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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 �3--�3 <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org ��303-�3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � � G J'��Jl�l L�' J Gl.C4- C�,n i%S '�-- � <br /> PROJECT ADDRESS � <br /> �i;') Rv �. 1%t 1.'�, <br /> Owne� Mail Address Cify Stale/7ip Phone <br /> �a V1 L'�- �Dfi� <br /> Tenant `� Mail Address City Stale2ip Phono <br /> �1 Z y <br /> �.1�-,Zv L� fE'-��c� ��1"r,� P��- 7�'°�4�i��1�..:,, ,.L t,,t,�- �ib'29� 51'��'75�{ <br /> Elecfrica)Contractof Mail Address City Slate2fp Phone <br /> I'l� Cl.t� .l21L. �c7 / f� /-�- _ W U �li �� <br /> Slate Lice�se Number Contract rico of Work <br /> /1 n r� �� c�< <� <br /> Propos d Use of Building Conlacl Person (Plan Review) <br /> Descriplion of Work lo Bo Done: 1 Il��(�:��/'����--�5 -�V'M'� ��:1��11� <br /> 1') l�l�� �.r� �1-t� S��oti1 C�,� � �'� Wi�L I'S Z -�X l� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, h1C OR AC CABLE. 5 O <br /> �' (�� <br />� CITY OF EVERGTT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily tI��t 1 havo read and examined fhis application and know fhe samo fo Ue We and �13 03 - D q� <br /> correct. All provisions o//aws and ordinances govemin�fhis typo of work will bo complefe� <br /> u�hefher speafied herein or noL The c��antinc�o(a permR does not presumo to givo aufhonfy fo <br /> violate or cancel Ilio`�rovisions o/any other stalo or locallaw regulafing construc6on or Ihe <br /> performance ol corstruction. 7'hat 1 am autho�ized by thr o�ti�ner o/fhrs property to peAoim th�: <br /> work/or which epplicalion is mede and 1 compty wifh Ihe Slo(e Contracfors Lew 18.27 RCW ar,d — — - - — <br /> 29G.200 WAC. <br /> _ (! ' ;'�✓1��� I�LL.L.'�'.i �� � Z i ' � <br /> Signaturo <br /> D3i3 <br />