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ELECTRICAL PERMIT APPLICp�TION <br /> CITY OF EV�RETT PERMIT SERVIGES ����--063 <br /> 3200 CELZAR STREET, EVERETT, WA 98201 <br /> 425-25i-8810 - FAX 425-251-8857—www.everettwa.org a-'��{`�{/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �'� 32��ra u��-c� <br /> PROJECT ADDRESS <br /> yz)'3�� s/i� <br /> �.�=�N LJ��I��c-w�. f:-'?�fsl2�,�1 Lti/� -rid'1�3 <br /> Owner 1,7ai1 Address Gty State2lp Phone <br /> S�tri?� S�tt�u! _ <br /> Tenant Mail Address CAy Sfale/Zip Phono <br /> �� EI.G�C ��77 ��r�cit A�r/� �3dZ t�r�c�1.� ���e� <br /> Electrical;Cntractof MailAddre,s Cily Slale/Zip Phone <br /> L/ it'(r ��-�"7% �/.��� �/C� uf2ir�— �� <br /> ,JUOa <br /> Slate Ucense Number Conlract Price of Work <br /> . S%'/� �_ �l���.�'d"3 a���' <br /> Proposed Uso of Buildin� Contacl Pers m (Plan Roview) <br /> DoscripUon of W ork lo Do Done: ���✓lO /l trfa– l'Y�C'"�� �� �-'t2 �Q l�. <br /> �..)c�. � '7�v a�..n_ P rJ L. <br /> ��_ � c3z � '� G(G �'��_ S.�c U�-�-s�m o,�� <br /> NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO FEE <br />� BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LO:AL SALES TAX CODE IS 3705 <br /> I hereby certi/y thaf!havo read and examined fhis applicafion and know the same fo be fruo and � <br /> conect. llll prot�isions olla�vs and o�dinances goveminp this type ol work nill Ue comple(ed ����2 �'�����,� <br /> whetherspea6eAherein ornoL The granling o/a pemuf does nofl�resumo fo givo authonfy(o <br /> viola(o o.�cancel tl�e provisions o(any ofher state or local la�v regu ating consWc(ion or tho <br /> pedomience o/construcfion. 77iat 1 am aufhorized by fho owner ol this pmpeRy to pedomi the <br /> work/or.�alrich application is mado and I comply wifh tho Sfate Con(ractors Law 18.27 RCW ar.d <br /> 296 lh'AC. <br /> '�L/ U �� �" � <br /> � �!% ( <br /> Sic�natur — Uate <br />