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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 �j �2 Z—��'f <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM CD/�` �o� <br /> o � #�g�� <br /> PROJECT ADDRESS � <br /> �.,Gn ) K.L��/, / C� l/� ! �P / �/(�j7�LiE�:� ��zSO �-�sya�39 <br /> �wner fdail Hddress Cit Slate/Zip Phone <br /> ,(���� a�cS��a�-���r-cZ� 98zo l yzsls9-59z9 <br /> Ten� � Mail Address Ciiy Stale/Zip Phonc <br /> 1�Ccf"r��.-(��.� �'�a9%i����� �'v�ut?l� 9�20� �/zs lsz-��cn <br /> Electrical Contrador Mail Address City Sfa�eiZip Phone <br /> DR/f�.�� 9z�� D � /5�0. o0 <br /> Slate License Number Conhact Price of Work <br /> ���--7—f�-/ <br /> Proposed Use oi Building Conlact Person (Plan Review) <br /> i <br /> Descnption of Work b Be Done: � �- � Y y �� <br /> , � .Z��zei� �.GazLa-e-� �� -���ct-- <br /> NOTE: WIRING IN NON-DWELLINGS IS RCQUIRED TO FEE/� <br /> BE IN RACEWAYS, MC OR AC CABLE. ,SS! �-.//7., /� <br /> ZY' X SG / <br /> (> lJ l <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereGy ceRily Iha�i have read and examined fhis applicalion and know fhe same fo 6e true and �Q�Q�- DcLC� <br /> currect. All provi;i�ns ollaws and prdinances governmg fhis type ol work will6e complefed <br /> wG9fher specilied herein or noL The granfing ol a permd does nof presume fo give aufhority to <br /> violaie nr r.a��cel the pmvisions ol any other sfate or local law regulafing consfruction or the <br /> peAormance ol�o nsfruction. That 1 am authonzed by the uwner ol fhis propetly to perlorm the <br /> work/or whi�fapplication is de and 1 comply with fhe Stafe Conlraclors Law 1827,RCW and <br /> 296200 WA . y <br /> i <br /> �� i <br /> � � �� �'07�-O 9 <br /> � Signa " e ' Dale <br /> v <br /> _ _ _ � <br />