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------ -- - � <br /> ELECTRICAL PERMIT �'�P�LICATION <br /> CITy OF EVERETT PERMIT StRVICES <br /> 3200 CEDAR STREET, EVERETT, W498201 � � G � o�� <br /> 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br /> �- � rI0 / _�O I> <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> _ _ _ i <br /> I <br /> � �r�� ,� l „' '� ; �� , , ��� i) /,�/Ul� �= C ��i�'�t� � <br /> PROJECT ADDRESS I <br /> I <br /> Owncr hlail Addwss Gty 51ate2ip Phone I <br /> �1�«ri/J�f% f� s T/�i �c�7�r.�f ,J`/52/:1L-' <br /> Tenant Mail Address Cily State'Zip Phone i <br /> S�1�E �i��T����N� ��� � t��l i�1.��c� r�i s �,� �Si 4� i <br /> EleC�rical Con�raClor Mail Address Cily Slale.'Zlp Phone I <br /> S !� ��1- r f <br /> � S/,I� iN;� �t� �' �r' 1��� �ZS���'� � <br /> Sfate License Numbcer Conlrar� price ol Wort. I <br /> i <br /> ��. 'd /�E� �a� �r .'• f _ I <br /> Proposed Us�ol Building Con��c� Person jPlan Review) ! <br /> Description of Wark to Be Done� /N:%74��I f C'<i� ��� �C 2 [7 GT1 ��f' G Ce G/( 1 'rY!3 �I <br /> i,7rl C.: CC1-*� 4 Cur s �Oc� � , �!l.t5 G�.T-L< r3 ', <br /> � <br /> � /'_4`�r'c r l�l t .c ; -- I <br /> NOT[ WIRING IN NON-DWELLINGS IS REQUIRED TO PEE I <br /> BE IN RACEWAYS, h1C OR AC CABLE. I <br /> CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 L u r�C I ��_�, <br /> � � �.- / - <br /> I hc�mb�� �oru/} fhnf I hnvr�eaJ and rxununed fhis appOcr�hon;uid know fhe s�nne h�be f�ue AnA <br /> e�macf� All pr��vitiions ollaws and oid�n,�nccs govern�n�this t}-pe o/�tnrh will bt� cortrpleled <br /> ; � whefher sp��a6ed herom cr not. The granfinc�o(a pernuf does not xcsume fo g�ce aufhority fo <br /> v�olafe or cancel lhe prowsions oI nny ofher state or local law ree�,ifahnc�construcfian or fhe <br /> peAonnance ol consfrucfion. That 1 ar+au(honzed by fhe owner o/fhis property to perlorm the <br /> wo�k lor K�hich applicefion is maAe nnr' � cornpty wdh fhe State Confracfors Law 18.27 RCW and <br /> � 296.200 WAC. <br /> ._.� ' /�� / � c� <br /> � i_ /_� . '- - /�/ !) ..,��, � . � �� e.- �- , <br /> —�� � —1-=��-------- <br /> Siqnrdiuv Date <br /> I <br /> ��I . . ___ __ -_ "_._ __.—._______� <br />