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1 ( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT 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 -DEBIT 6 CREDIT CARDS ARE NOT ACCEPTED <br /> !'�0 9 2�,��;�%�� . r„�l 1�� ��,�o� <br /> ROJ�ECT ADDRESS . <br /> �u - ;nv �n� wP � <br /> Owner Mail Address Gy Stetelap Phons <br /> ��WIVYkYI l�f��.n�� �:��Fm �lj�,�l �U��. �ixlvSv;��t ��111� y�3'e�7� .��6if'8y3S� <br /> Tenant �,,,,�, S���Mz MailAddress aty staterziP �aie <br /> ,�l M� G 6� l��,� I��/I7 . <br /> Electrical ConhaCtor Mail Address City Statel7Jp Phone <br /> c�y 2��� �' — <br /> Slate License Number Contra Price of Work <br /> �.� ,�(� <br /> Proposed Use of Building Contect Persan (Plen Review) <br /> Description of Work to Be Done: ���✓��'��ih� �9u,.�/!t'� _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �j� — <br /> U <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi/y fhaf I have read and examined fhis application and know fhe same to be hue end <br /> correct. All provisions o//aws and ordinances yoveming th(s type o/work wlll be complefed <br /> whether specified herein or not. The grenting o/a pertnd does nof presume to glve auMaNy fo <br /> violate or cancel the provisions oI any ofher sfafe or local law reguletlng conshucfion oi the <br /> peAamance o/consfruction. Thaf I am authorized by the owner o/fhls property to pe�/orm the <br /> work lor which application is ade and 1 comply wifh fhe State Conhac(ors Law 1 E.27 RC W end <br /> 296200 WAC. <br /> ��� " oy � os <br /> Signatur Date ' � T <br /> �� I U <br />