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1 ? <br /> i — <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 �� �p/"d6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C'O 6 I I-OO( <br /> , <br /> � ' � , 1 , � � fl'�'� //\� � �� i/ <br /> PROJECT ADDRESS >C' G - G S - <br /> G�GG <br /> ���. .I lti �, r. �r,<<� <._ir � l� <� /%�c�,Ec>> N�„�� /��'��N��r' � �„ ��N 9s-".3 <br /> Ownef Meil Address City £tale2�p Pho�B <br /> Plo/� - <br /> Pl3/'l-,� Mu2��/fJ'�`' �`)l l,7 �r; �-� [ ����U [ /•; cUt1 q�F.?�':`_� G �/- -2� 2 <br /> Tenant Mail ACtlrese CAy State2�p Fhone <br /> I '� � 1 c��'� 'n r � r �� �; � � S� I C- � ���z'C-;c'� en l�i' ;l , c� �<,cr�� , �v,.a q�_� � <br /> Electrical CnnlretWr .�ulail Atltlress Ciry SleteR�p v 7� � �'� P��y�,e3`� <br /> �� <br /> �'t �� i � 7 r. �,%��� ,•, , �� �y�Cc <br /> State Llcense Number Contrad Price ot Work <br /> � , � - .� / i ' /,�lC/_ S74N/�E715 <br /> Proposed Use ol[3wlding Conlact Person (Plan Review) <br /> DeScripUon of Work to[lr, Unne � � �� ���' ' � !_ / ' <br /> ----__ __--_.._--------.._. <br /> NOTE WIRING IN NON-DWELIINGS IS REOUIRED TO FEE <br /> DE IN RACEWAYS. MC OR AC CABLE <br /> _ _ ___— — --- _. <br /> CITY OF EVERETT LOCAL SALE�TAX CODE I5 3105 <br /> I hereby ceAily fhaf 1 have read anAexaminod fhis apphcehon and kriow fho snme(o be fn�e and <br /> r.unocf All provisions ol laws anJ ortfinanr.es governin�this type ol worle will be complefed <br /> wlrethor speciGr.d hemrn or nnt The granfiny o!n pemuf does nof nesume to,qive aufbonty to <br /> violalr, nr cnnr.el fhe prov�srons ol any o(bor stefe or local law regu�eling consfn�clion or the <br /> peAommnce o/cons(nicfion. Thof I em nulhoneeU by Ihe owner ol lhis pioperty to poAorm fhe ( ; � <br /> wo� lor which npp6c�fion is madc nnA 1 comply wifh fhe Sfnfo Confractors Lew 18.27 RCW and (�� � <br /> 296 200 V✓AC I - <br /> , � � � <br /> - /i , /. �,i:-� /���i/ � <br /> --- .�...u��.L f. ,�s_,. --T � <br /> Slgnalure � Dale <br />