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ELECTRICAL PERMIT APPLiGATION <br /> CITY OF EVERETT PERM�T SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> " L/;.-- <br /> '�-� G� �� ���c���te;� � <br /> PROJECT ADDRESS <br /> (:Zr� �= S�8 52 �p�`I V;�,c rf- (,���G�n�-i,.-I-� UI� l{�2�� <br /> Owner Mall Address City State/Zip Phone <br /> ar� �(`� I'l r����.wN, ����- �,✓� ���zo� <br /> Tenant Mail Address City Slale/Zip Phone <br /> I/ C� 'l 7 <br /> � �7�eC� .-�C.t.� I-L7 r T tn.'�'^� �L � �. �1:,;.�-7u�n J 1 . Sf'.r.Ll"�, wIk �"I ��J`A ZJL�lG'i-I7�I`I <br /> Electrical Contraclor Mall Address City State/Zip Phone <br /> �s I 80. c,"� <br /> �v 1�i'�C-?L�I I 5 �-lZ <br /> State License Number Coniract Price of Work <br /> �{�;�1j,.,1��L,�_� �7��-7:;}_i,:�:� ,_�.��i <br /> Proposed Use of Building Contact Person (Plan Revievr) <br /> Descriplion of Work l0 6e Done: <br /> .1 v, 1�,l�r k�m �� v� � 1� `fi��-�>,�i��-. <br /> 1 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> ! ' BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> � <br /> CITY QF EVERETT LOCAL SALES TAX CODE IS 3105 q <br /> 1 here6y certily that I have read and examined this application and know the same to 6e true and �� �3 -� /C1 <br /> correct. All provisions of�aws and ordinancas governing this type of work will 6e completed <br /> whether speci(ed herein or not. The granting o(a permit doas nnl resume to give authonty fo <br /> violate or cancel the provisions o(any ofher sfafe orloca!law reguPting co utruction or the <br /> performance o/consfruction. That 1 am aulhonzed.by the avner o/this properly to perform the <br /> work/or which zpplicalion is made and 1 comply with the Sfafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �'��v �i?�- ��, /riI r�z <br /> SignaWre Date <br /> I_— <br />