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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 7`.� ` �� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org C�1 tl7— D� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> f�' )i� �/�l�d.+'T /Za! <br /> PROJECT ADDRESS <br /> 1� /'f<.� ��1�•''ci7 � LLE /ic/��u� �ua4 7%G�y <br /> Owner � Mail Address City StalelZiP Phone <br /> �L��/f/�Lrc� ��G�/i' J�e��/C�C ,E�CJ��_..�i GLG4 <br /> Tenant Mail Address Cily SfatelZip Pho�e <br /> T � F/�e ��� ���� �iyi Pq��,�;��n.� �. � �kvT. <br /> ElecVical Contractor Mail Address City StalelZip Phone <br /> �T L F�� � �u�— R.�7 �CLLY. `�` <br /> S�le License Number Contract nce of Woric �' <br /> li�llti �'cir� J//?/U�> JLf u:�9-F� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ut Workto 8e Done: i7Gi.�'-e^' 1'v.� o��f �P?S �-- r-�Si �''u`°CTT <br /> NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS,MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certi/y that I have read and examined this application and know the same to be true and �I ) v�- —�3, <br /> conect. All provisions o/laws and ordinances goveming this type of woAc will be completed l� <br /> whether specified herein or not. The granting o/a permit does not presume to give authority to <br /> violate a cancel the provisions o/any other state or local law regulating constnrction or the <br /> peAormance o/construction. That 1 am authorized by the owner of this property to perform the <br /> work for which application!s made and 1 comply wifh the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> � .`l�-C � - � - %/ <br /> Signa re Date <br />