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;_ <br /> ELECT�f�ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 38201 ` � �`O � <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.ory � p�O l�O 6� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �a »j � Je.���(�C�r\ i,v�'� <br /> PROJECT ADDRESS <br /> ,� 1 i� ,�J S('e..1`�� � <br /> Owner Mail Address City Stale2ip Phone <br /> I',��-e-apl��;� �eo��— (% CC,�I� <br /> Tenanl Mail Address Cily Slale2ip Phone <br /> S-t�.��� ct,�� C � .-�-� v�l/ 7 S� lo Z /:' C � �i- �� 5 7 �I <br /> [lectrical Cont�ac�or M2il Addres Cily State/ ip Phonc <br /> 2s��'Zc>- f'.=1 <br /> S-(-�w;-c�- q 5� 12 `�'� � ?��' y_ <br /> Stale License Number Contract Price of Work <br /> t2Fc��\ c����c�� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriptiono(WorktoBeDone: ���y'�� � `���U��u� G'tGr!/� � L1r� s� ��-�� � <br /> � � ���U.`C' �l\6LC� / LL�C1��Cl�s7.5 � .S — ��'S � �-irYU � _ <br /> ���� O__`(i��J�q � � f�� �`,"�� _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> [3E IN RACEWAYS, MC OR AC CABLE. <br /> IGITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerli(y fhat 1 have read and examined this applicafion and know the same fo be frue and <br /> correcL All provisions of laws and ordinances governin�this type o(work will be compteted <br /> whether speci(ed herein or noL The granfing oI a pernut does not presume to give authonty to � <br /> violate or cancel tbe provisions olany other sfate orlocal lau�regulating construcfion ortho <br /> pedonnance o(consfruction. That 1 am aufhonzed by the owner o/this property fo perform the <br /> work lor which applic fion is made and 1 comply�vith fhe Sfafe Confractors Law 1�.27 RCW and /j�� <br /> 296.2��WA�. /�G1�/�—i/� <br /> , <br /> ,� _ �s�- z �v5 <br /> iynat r Date <br /> / O U� l <br /> ���Ul� <br />