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��!_ECTRICAL PERMIT APPLICATI[�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.or� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PN <br /> � � � �"(� � <br /> t i�� �� l �Ci � ;.i f�' <br /> PROJECT ADDRESS ` <br /> Owner n!all Address City State2lp Phone <br /> 1 n l <br /> ���;�/Il�/n � ��l�l�����`�C'� LL//'.ia`h�S �G�N�. �X�� .jC �� S�,i'��,- <br /> Tenanl Mail Address Cily State/Zlp Phone <br /> �==������� �,;� ��a� ���,i�tu, ,� �Q�: �. ����7�� ►�.a� ���.5���.��,, <br /> Electrical Conlrador Maii Address �Ciy State/Zip Phone <br /> j�Lc • <br /> �— <br /> �� �rC��Y�(�G1-Lr� •��-� � -o `r�3 �E��;�.: <br /> Slate License Number Contra Price of Work <br /> � I��' r> r?�IV�� ��iI.I ;', ,- �LL <br /> .� <br /> Proposed Use o( uilding Conlact Person (Plan Review) <br /> _.._i r� ��( <br /> Description o(Wor1c lo Bo Done: ��f/L�� �L�� •�'���r � C�� � <br /> % i u �t� s : .���ii���1���. c�t� , C%c�f([�f5r �;� �� ,S���,�,�-5s�i���� r �l vri � <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 /> !hercby certily fhaf I have read and examined this app/icafion and know Ihe sanie fo be trua dnd <br /> correct. A/l provisions o/la�vs and ordinances govemrng this type ol work will be compleled <br /> whether speci6ed herein or noL The granting oI a pemat does nof presume to give authonfy fo <br /> violate or cance/fhe provisions o/any olher state or local law regu/ating construcfion or fhe <br /> perfonnance o/constnicfion. Thaf 1 am aufhonzed by the owner of this property to pedorm the <br /> �ronrk lor which applicotion!s made and I compty with fhe Slate Contractors Law 1827 RC W and <br /> 296.200 WAC. <br /> '`� ;� �� � . 7 [��.— � � <br /> r , '� � �� , L-- <br /> Sign3lu� r Dale <br /> � ,�y�'� 1� � <br />