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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 />_ � / ,, .� /; _ <br />i/ � � � 1 ��! _'' Yi�-� �-��" ..jG�'�� ,��! �.`/ �,� <br />PROJECT ADDRESS <br />l � ' ,�L i �i"�' S i �� !�% � fi7 �c / ,� :,� ,� ��f �,< < � , � `.; �- ; � , ,, �� j�; c � � ;. � ��� �., _r i� c C�i i' >?G %C�/ <br />Owr�'er J Mail Address City State/Zip Phone <br />71;u'._t� :<�.- j�. <br />` .. ��` ��-;;�.SiC� /�-i c �7�/ / �C 1-'t�� �'1,� y'�. �� J�jC' %%-� ��-� �� �- �G��. -�/. �,.�r �/:�c'�' ��/ <br />f <br />Ten2nt Mail Address � City 5talei7_ip , Phone <br />�s-?/u-�l7� <br />l`'f G �-/�?_> �%r�� �' C; `�L'!J `7 �/" C_( r'�`"�� _> j{'l f��� �:li''';'-� �'���� ��i ��%'(�P ��",�-a �)�>/f <br />,,, ' <br />Electrical Contractor Mail Address Ciry State/Zip Phone <br />� <br />c — <br />'�� � /C '-'1,�L. L i � � (� ��/ � �"C'�, - <br />State License Number Conlract Price oi Work <br />, � c�vi �'� 2C�- ���-5��� <br />Proposed Use of Building Contact Person (Plan Review) <br />Descripfion of Work to Be Done: �%� ' ��i'� �' r� C `i % ��' � � � � � /V c"L{ ,'�7` ��Y� -� �� ��%"�i !j��y-= <br />C' f G �C� %) �7% C ��, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CAQLE . � <br />��� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify thai I have read and examined thrs application and know fhe sarne to be frue and <br />correct. All provisions of laws and ordinances governing this type of �n�crl< wiR be completed ��� C' 4.�� u <br />whether specrfied herein or not The granting of a permit does not/� resume to grve authorrty to <br />violate or cancel the provisions of any other state or local law reyulatiny construct�on or lhe <br />pe�iormance of construction. That ! am authorizeci by [he owner of th�s property to perforrn the <br />wori< for which applicaiion is made and ! comply wrth the Sfafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�'; �� <br />�� L�� ��-�� ��G ��/ <br />Sianat' e Date <br />% <br />