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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �a7`o G <br /> :�200 CEDAR STREET, EVERETT, WA 98201 7 <br /> 425-267-8810 - FAX 425-257-8857-www.evereltwa.org ��6 b7 `/ 6 9 <br /> APPLIG.4TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> / � .3 `� � ��/_',� l l�'U 1 5 1 <br /> PROJECT ADDRESS <br /> s cuN ��( � ��v �'����1'1�c.ro/�L yz.� �t7� - 7Zy7 <br /> Ownor Mail Address City Stata/Zip Phone <br /> Tenant Mail Address Cily Stale2ip Phone <br /> �l! � ��IJ 1�/ ECE�,��IL �'0 iiJ l <br /> IEloc�dcal Conlraclor Mall Addmss City Slate/Zip Phone <br /> M�viNFLCO =, lV3- _ <br /> Slato Liconso Number Conlract Pnco of Work <br /> .S �� � <br /> Propos�d Use o(Building Conlacl Person (Plan Roviow) <br /> Dosciip�ion of Work lo Be Dono: /I.. �j' 1;✓ S{�}( _ �,U A/V�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> 3E IN RACEWAYS, MC OR AC CABLE. y 7 O O <br /> CITY OF EVEREfT LOCAL SALES TA% CODE IS 3105 <br /> I lrereby ccrtity Ihaf 1 have read and exnmined this�pplicafiun anA know fhe same to be fn�e and <br /> conecf. AN pruvisinns o(laws and o�Auiances�ovennng Ihis fype ol work will be complefed <br /> whefher specilieA herein or nof The r�ranhng ol a pennd Aoes nof resumo ro give euthnnty fo <br /> violate o�cancol fhe I7rovisions o/any olher sfete or local law reguPfing consln�cfion or me <br /> periomiance o/construcfion. 7het 1 arn aufhorizcAhy the ownnr o!Ihis property fo peAorm Ihe <br /> wo�k lor whicb epplicafion is made nnd I comply wiflr fho Sfate Confrac(ors Lnw f0.27 RCW and <br /> 296.200 WAC. <br /> ��i"�, .. ���'f�— � _ �-r- �b <br /> —��ipnaWre � Dale <br /> . U����� �� � �� <br />