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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C� V a� ,� 7 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �s <br /> �.,-a�o8-t5z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> L��� (,�,Y��c„cl� '�C�l <br /> PROJECT ADDRESS <br /> ' 2�6^4�4s���s7� <br /> J%'i!!SI r�i%9� <br /> Owner Mail Adoress City Slate/Zip Phonr <br /> Tenant Mail Address Ci�y SlalelZip Phoite <br /> , � , <br /> ��l��1C;c� f'r.�c.� YiC_ �o , 6>u 137� rhnG�orvi,�SG, c��� .�i �i7y��-y�� % <br /> Eleclrical Contraclor Mail Address City Stale2ip Phone <br /> �+�✓,'�Df'rG�" `�6�5—/vf� /2_v � . - <br /> Stale License Number Conlract Price of Work <br /> , <br /> �l, %� �cs,s%.c, G-c..,,� et� <br /> Proposed Use of Buildinc� Contacl Person (Plan Review) <br /> Descnplion of Work to Bo Done: ����=1�-�?.� � C C :�l�`S l'�i,i'i� Zi�S'�GC �� /V �j:i�R� <br /> �r,—f-7/ .D�G�'t'K%r7 ��1//VU��-G�l /�✓'�CL�'��� ���/ �Q// �G. rG .L./^,S�to�, <br /> �_� ✓ <br /> �'X��� �w��' �,�c�,�..� �.-{�1�r�� <br /> i <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 /> 1 heieby cerlily fhat 1 have read and exandned fhis applica(ion and know fhe same fo 6e true and ��—�L[� ._ �t�Z <br /> correcL All pravisions ol/aws and ordinances govemmg this type o/work�vill be complefed <br /> �vhetlier specibed herein or noL The�ranling o/a permrt does not presume to give authonty to <br /> violafe or wncel fhe provisions o/any other stafe orlocal la�v re�ulating consfruchon or fhe <br /> pedormance o(consWchon. That 1 am aufhorized by the o�vner o/fhis property to perfonn the <br /> �vork for which applicafion is made and 1 comply wifh fhe Sfate Contractors Laiv 18.27 RCW and <br /> 29G,200 WAC. <br /> /� i� <br /> � / j- <br /> '_'� :�. / �-��— '—� � � �� � L� � <br /> ` Signalure " Dale � <br />