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1� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982Q1 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �,� ,� �� �z b iz�l C'•,71 c, �.� l� /�-� <br /> PROJECT ADDRESS � <br /> l�i�'�t� N l�YCi C,. ;' S' <br /> Owner Mail Address Ciry Slate2ip Pi�one <br /> Tenanl Mail Address City State/Zip Phone <br /> 9fo7G zcL 7!'G- <br /> /I � � c� �� /�c.�-c�,-<<% e �. ��, r'��x �nl' � /���-�N��,� ��tiri� 3ivc <br /> Electrical Conlraclor Mail Address Cily Slate/Zip Phu�e <br /> /� C I l=L �� � /l �.r '�2S?.'J <br /> Stale License Number Contract Price of Work <br /> �.� o� �/ J'/�C���� 'f D �l/`/ L��.f f/,1�✓ <br /> Proposed e of Buildin9 Contacl Person (Plan Review) <br /> Description of Work to Be Done: �ti/lJi1 <`91/�dG r-�? /�/t/n'�^ /� CDI�� �t°i!-�.i��i1 2 ���u�. <br /> n��) 1',ZsP S�%-�ivi,� <br /> � <br /> NOTE: WIRING IN NOh-DWELLINGS IS REQUIRED TO FEE <br /> i <br /> BE IN RACE4VAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily fliat 1 have read and examined fhis application and know the same to 6e true and �Q��q- ��-1�� <br /> correcL All provisions ol laws and ordinances govemma this type ol work will be complefed <br /> whether specified herein or noL The granting o/a permit does nof presume to give authonty to <br /> violate or cancel the provisions o(any other state or local law re�ulafing consfruction or the <br /> peAormance olconsfruction. 7hat 1 am aufhorized by fhe ownerol fhis property to perform the <br /> work/or tvhich appllcafion is rnade and 1 compfy with the Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. I/ �' <br /> ����i` ll� ` 2�'• ft Pi OSr <br /> Si riaWre Dale <br /> / <br />