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J _ <br /> � <br /> EL�CTRICAL PERMIT APPLICATirJN <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .5J aj ������ 6;�.-=7-,J r,J rt- Y <br /> PROJECT ADDRESS <br /> ;��e,�;� J L. �, �,, , J �� �1-,�L62��,J cJA-Y �7J,�L.,-r'— �/:f— ��Cc1-� <br /> Owner Mailkdd«� Cily � State/Zip / Phone <br /> yz� ��� -3z�/ <br /> Tenant Mail Address Cily Stale/Zip Phone <br /> �j�(i�("r� Jr��('v�Cii� �D /�0 f�i.��y`� /� � /. i r�it�!/Jo o� (/�/Y 1�U.�, L��- �L —5" 7y <br /> Electrical Conlractor Mail Address City State/Zip Phone <br /> ]o <br /> l�l'{/ 2%SS �S��f�� —� '� ` (� � 5��� �—_ <br /> Stale License Number Conlrecl Price of Work <br /> ti�<.,) /�/.�)�-t !U ) �c��rfT �� t ;�'n O ^�_/ <br /> Proposed (lse of�uildin Conlact Person (Plan Review) <br /> Descriplion of 1Noric to Be Done: �!%J� /U _!J� ' `��C � �� ���/1%�"� G Fi iC� l�l�l�i_n'( <br /> NOTE: WIRING IN NON-DVJELLINGS 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 certi(y that 1 have read and examined Ihis applica(ion and know fhe same to be tnie and �O���'"����� <br /> correcL All provisions olla�vs and ordinances governmg fhis rype of work will be complefed / <br /> whe(her specihed herein or noL The granfin�o(a permit does nol p�esume to give authonty to <br /> violafe or ca;;cel the provisiens of,any other sfafe or local law re�u/afing construclion or the <br /> performance o(construction. lia 1 am a Ihcrized by lhe owner ol this property fo perlorm the <br /> work(or w(iich applicafion is��ad ar d"1�rnpty�vifh the Sfate Coniractors Law 18.27 RCW and <br /> 296.200 }yAC. <br /> i �)- <br /> f�YU?�LJ " // / // / <br /> . ? ,, � 'j <br /> _ / <br /> � Si�naWre Date ' <br /> _`.__..._ .. ___'_ __. . _ ._ . _ .. ._._____...__.._.___— . ___' ..__'—___..—____'_— � <br />