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/�- ,r <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES io 3�7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �'�7/O—/(6 <br /> 425-257-8810 - FAX 425-257-8857-www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> = '�-7 U���� �T �� .%�� <br /> PROJECTADDRESS '�/� S <br /> L <br /> Owner Mail Address Ciry Stale/Zip Phone <br /> TenBnt Mail Address Cily State2ip Phone <br /> !^ ,. !,� , � [.�i�ii.!IL..� /'1.-�i;�4��✓c .�ir'/�7tL :�(�� �n %2> ` >��/� <br /> Electrical CoN�aclo� Mail Address Cify ' Slate/Zip Phone <br /> / ��t'> <br /> r. r. l.� i��� ')/1�j�1��. _. �.��� — <br /> �r(� <br /> Slale License Num6er Contract Price o(Work <br /> c �(-r i .'1= <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Descriplion of Work to Be Done: �_� „�-✓���t:l �.'��j��-T�•:', j LUm �'"N , /��^�-` C✓`�:ry S <br /> ✓ � � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat 1 have read and examined fhis applicafion and know fhe same fo be We and <br /> correct. A/l piavisions olla�vs and ordinances governmr�this type o/work will be completed <br /> whether speabed herein or noL The�ranfing of a pemut does not presume fo give authonty fo <br /> violate or cancel fhe�rovisions ol any ofher sfale or local la�v regu/ating construchon or fhe <br /> performance o(construcfior. Thal 1 am aufhorized by the owne�ol this property fo peAomi the <br /> wo�k lor which applicafion is nrede and 1 comply wilh fhe Stafe Cont�actors Law iB.27 RCW and <br /> 296.200 WAC. <br /> j� — i' <br /> - i!-' �i � ) `�;") � , <br /> , , ,. '�. .;�- ' C. <br /> Signature Datc /^� <br /> � � � — (lv <br />