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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMI'�� SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —v�nvd.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FRONI 8 AM TO 4 PM <br /> a � os� eRo�,�,�y <br /> PROJECT ADDRESS <br /> �q�,1 : ��mcf�e '> � ;�,�,: <br /> Owne� Mail Address City Stale/Zip ���hone <br /> (2 � H « I C�ueresl,� `d`lo� SRaqd�a�y ��e�e� WtA �j�o�� 773- 3 � <br /> Tenant Mail Address City -Slaterzip Phone <br /> Llewely� E�e�tr�c.. yy�y Gr��N� �A�E £ve_r�'�[7' c�1 ►9- 4�� `r'�7'�o3lOD <br /> [IectricalConlraclor MailAddress City ' Stale/Zip Phone <br /> LLEw �E� 9 r90W � 33�,00 <br /> Stale License Number Conlract Prico o(Work <br /> � �.�-a,�` � <br /> Proposed Uso of Building Conlacl Person (Plan Review) <br /> DescriptionofWorktoBoDono: RG�ov� Cord C�Nd pl.tig LoniNe�,f-..c( L.`�1�,T'S <br /> SNST^��- 3 S FT Flo�o¢�esc�,� L�_�kt T'.x tv.res rc�+1 er.�e 5�+�+cJ� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. `-�� <br /> 5z� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily O�at I have read and examined fhis ap��lication.md kno�v thu same to be true and � I 2 QZ _ ���l <br /> correct. All provisions o/larrs and ordinances govertung this fype o(�rork n�il!bo completed <br /> u hether speci6ed herein or noL The c�ranting of a permR dnes not �resume to giro aufhonty to <br /> violafe or cancel lhe provisions o/any ofher sfate or local law regulafing consiruc:'ion orthe <br /> perfomtance o(consWchon. That I am aufhorized by the o�vner o(thrs property to pedortn the <br /> work for which application is made and 1 canply u�ith the Stafe Contiactors Law 18.27 RCW and <br /> 296.20014�A C. <br /> r7-�«./�--G. /�-6--r-''--- �a-- O�—vt�(� <br /> �ipna re ' Date <br />