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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S�Jq <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org a � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��/D�--OI� <br /> i_i i 7 N J�I�I�U�L ��-f-�)�= <br /> PROJECT ADDRESS <br /> ,T1�,„c I��a,��e� Z�Z� �v���� �oc;- ��� r�k�r���-1- �ala �',52� i <br /> Owner A1ail AdAress Ciry SWlelZip Phone <br /> ���1�E;n �--��-�-�� �� �z�z� �,Je-�-n,o« ��e �1e��>1-�— kl� �t 2�1 <br /> Tenant'��v Cv����� 6failAAdress City StatelZip I �one <br /> ��i����� �1�����1 ���t'iL �nC. ���3(� _���w�,��.,�< I�i�nc�c< < �� ���BJ�� '�T�-l�%/-�'y <br /> EleclriCal ConlraClor A1ail Address City State/Zip Phone <br /> ���1��1�,U�= G;� 1 ���� ���I� =���SUU . —' <br /> Sla�e License Number /� I� Conlract Price ol Work <br /> l� <br /> '��1`�tll�� f�C�Ci4V�C� L�����CC <br /> Proposed Use of Ouildin9 Conlact Person (Plan Revie�v) <br /> Descriplion o�W ork lo De Done: �i��� Cr� l.L I� L� l/��� I � � v �Il o Il �= 'J Y7Gt�L7 � <br /> ,��` <br /> �� ��Cv,�l-Z 0��� ��'I(�D�� <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 hereby ccrti!}�fhaf 1 havc�ead and examined fhis,pplir.afion and kno�v Ihe same fo be frue and <br /> correcL All pi�eisions ol/aws anAordinances governinq fhis type oI�vork will be complefed <br /> �vhether spea6ed hcrein or not The�ranfinc�ol a pernid does nof presurne to give authonty fo <br /> violate or cance'(he provisions o/mry other stafe or local lmv regulafing conslruction or the <br /> peAonnance ol construcliai. Thaf I am aufhorizeAb}�fhe otvner o/this property to perlorm fhe <br /> work lor�rhich applicafion is made and 1 comply�rifh fhe Sfale Contrac(ors Law 18.27 RCW and <br /> 29ti.200 l4�AC. <br /> _� �� 1 <br /> � I <br /> � ;�t � 1�z�� l4,�1-iti- L -�� - J`l - <br /> Signature � D lu <br /> � � ��GZ-Q1 �1 <br />