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( <br /> 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 G r///✓D� / <br /> E9 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> s � i � �3n.�� � A�c , s r<<. c <br /> PROJECT ADDRESS <br /> J 5 rl �n� 3�'�/ l�a�en�w � �;: � Evcn =� �`'� 9�'2�7 <br /> , <br /> Owne� Mall Address City State2ip Phone <br /> �75H- � 3g11 6�r�� �,� •,,,��`� C,��. F ✓ =� �' �"� •9 �z�1 <br /> Te�anl Mail Address City StatelZip Phone <br /> ALl- Co,�nrvotifhucST' y�,lC I �Z2a -2Y� S": flt/ Gi�. <<�-fT �✓c,CI�Y ��3 � <br /> Eleclrical ConUactor Mail Address Cily SWIo21p Phone <br /> � 'Z�3 F6LS/° <br /> � � L � o�y Q/Z2 QL�" II ���/7- �"Do o , <br /> Stale License Number Contracl Price of Work <br /> P �+�s , �,� � /� <<-+,r3 �-��� 0 �3r� <br /> Proposed Use of Bullding Conlact Person (Plan Review) <br /> 3 p�o�'S �f / � �n/5�- ��q l/o,�f �S 0*`i'�1-✓1 �r <br /> Descriplion o(Work to Bo Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO fEE <br /> BE IN RACEWAYS, A1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily fhaf 1 have read and examined Ihis application and know tha samo fo ce Wo and <br /> correcf. All provisions of/aws and ordinances goveming thls fype o/worfc will be completed <br /> tvhefher specilied herein or not The granting o/a pemirt does nof presume to give aufhonty to <br /> violafe or cancel the Provisions o/any ofl�er sfate or local law regulefing construcfion or fho <br /> peAomiance of construcfion. 77iaf 1 am aufhonzed 6y fhe ownor o/th)s property to perfomi fho 1 <br /> work lor which application is made and 1 compty wifh fho Sfafe Confracfors Lew 18.27 RCW and �I I � } <br /> 29G.200 WAC. � <br /> �� ��' '��� � <br /> 4 <br /> SignaWro Date <br />