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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.i�verettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _ �� l � 5 Cn�,'� Y AvC- <br /> PROJECT ADDRESS <br /> Loc.r �� P�nPrES�a�oi� Gi�: �l� S (,�J� ✓3`t =�;.2�'� I✓r) y"'b�J�-� <br /> Owne� Mail Address Cily Stale/Zip Phone <br /> Co�,;3•1 /Iv��uuc fitn,cy �rn�;it! 31��5 G�c�r ,5.��,-rs C1 �-vf,PF17' /A `14�01 <br /> Tenant hlail� City Stale/Zip phone <br /> �Af+L �LCCIK'Ir_ :�40`� I�c��auFq�c �u�; rv:Rr"TT L.v��1 5�ac'l y,�ti J a- l7dJ <br /> [IeCtrical ConlfaCtor htail Addiess Cily Slate/Zip Phone <br /> ,'✓A N 1_f C 1 `i J L (�!1 t� /r 'j!JD'-" <br /> Slate License Number Contrac�Price of Work <br /> _ �. � 1N1C. <br /> Proposed Use of Duilding Contact Person (Plan Revie�v) <br /> DescriptionofWorkto6e�ono: ,�Z CC-i�cCl.�(TS � � NEr1T 1�l{��I��3 UU tiG�'F <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i 1 hereby certily fhaf 1li�ve read and examined this applicafion and know fhe seme fo be trve and <br /> con�ecL Al/provisions ollaws and ordinances c�wemmg this rype ol work�vi/16e complefed <br /> whefher specdied herein or noL The granfing oI a pennd does not �rosumo lo c�ive authonty fo <br /> v�olate or cancel fhe I�rovisiuns ol any other sfafe or local law re�ul<�(ing constn�ction cr�he <br /> perfonnanco of construction. Thaf I am aufborized 6y fhe o�vner o(fhis properiy fo perfomi fhe <br /> work lor which applicufion is nrade and I cornply a�ifh fhe Stafe Confroctors Lan� i8.27 RCW and <br /> 2ss.zoo wAc �� � — � S/ <br /> � �, 'fC_� `1 `I- ��� l� <br /> '3ignaWm Uale <br />