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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 <br /> ( /O/ Asoc-i 0 ce /Ildr�.W .a tAr dt 4. <br /> PROJECT ADDRESS J <br /> ll <br /> ^7 f J& h4 .)av"eltr ,� 3 �7t)It'Wot ri ._ 7113 <br /> Owner �� Mail Address City State/Zip Phone <br /> Ke%l y Loc-i , <br /> 1� /4 i` Th/err i i, ��r ✓rn , - q z y 7nT9 t <br /> Tenant Mail Address gt,i City State/Zip Phone <br /> 118 <br /> ) C/zr- /c- <br /> V( CIP r', t4 nu0 fit ,y-,�,4 Cr . Ar / 6�✓c - lo.4' gYZ'3 OY "- <br /> Electrical Cctitractor Mail Address City/ State/Zip Phone <br /> State License Number Contract Price of Work <br /> C' ff-CCMeiiklifi .5 L A <br /> Proposed Use ofg Contact Person (Plan Review) <br /> Lily"- ?Z Z-71171/ <br /> Description of Work to Be Done: I nn S kill� ) L?4 J1 e is gA ) ,, ec r„t'1,44) <br /> ttr4lin-1- j ko,prw n-.i .,Pfi 7374 . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. t 5S'1 <br /> e C9 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ' jl hereby certify that I have read and examined this application and know the same to be true and \ b 6 lDcorrect. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does notresume to give authority to 4 <br /> violate or c.•-- .e provisions of any other state or local law regulating __ <br /> construction or the <br /> perform, ce of construction. That I am authorized by the owner of this property to perform the <br /> work f. which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.20c WAC. cliiii <br /> ,' / /�S— <br /> naturee Date <br />