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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /,�D �O �oac�(,�ac/ V �'.�� (,l�l���z0/ <br /> PROJECT ADDRESS <br /> f�j/6ir5in9 <br /> �iq J�111 ini Ma.v-f �nc •/BaG�o<rlrv��! �v.e►�-f�- 1,�'�9_�Dl <br /> p� � Mail Address City SIale2ip Phane <br /> �c�y±a� /�ob �i'aa�d w4� G-der�e�f-i,c�- �g2d 1 <br /> Tenant Mail Address City Slale/Zip Phone <br /> - 'EI �C' `ce5-isro .6 ��vP�,</�st �'m��ds�y�,t/A- `�as�����20� <br /> ElectnC21 ontractor MailAdaress Ciry SIa1e2�p 7a01� Phone <br /> �E�l�RE,Es�3�KF <br /> �ID � Oo �t�'� <br /> State License Number Contract Pnce o(Work <br /> � -- <br /> Proposed Use of Building Contacl PArson (Plan Review) <br /> � P y�s ��3-��z <br /> Description of Work to Be Done: �//U�,�e �l P("///,��(..�1'1/�(, r d"" Y �l�'�C� <br /> �_'!Y[:bG� {� ,cir d��r �'-�re y-Qrnode/. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hemby certily that I havo maAand oxaminod fhis applicafion and know fho samo to be Irao and L C��N ,�D l <br /> correcf. All prnvisons ol lm+�s:md o�dinanccs govemmg fhis type o!wo�ic will l�e r,ompleted <br /> whefherspecilied herein ornoL Tho granting ol a pemut does nof p�esume(o givo authonty to <br /> violafe or cancel the Provisions olany other slato or locallaw rogulaling consWclion or(ho <br /> peAormanco o/cnnsfn�ction. Thaf 1 am aufhonzod 6y tho ownerof Ihis property lo pedomi fho <br /> work lor�vhich applicafion is mado ar+QYi omp/y wlh tho Sfate Confradors La�v 18.27 RCW and <br /> 296.200 WA ; , <br /> � " —'--'. i <br /> ��1/' �- -2�i0 <br /> tiignature Date � <br /> � <br /> .\ <br />