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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-wrvw.everethva.org " <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> j�'�'?, ����� t,P`.ioao l�oAo (�x.c�, ��O - �-I l <br /> PROJECT ADDRESS <br /> � <br /> I h+c li"��,,: c_;c•. F3_-? u��x 3l01 `�C-r•�T�i W� `�n 12'-1 -ZZo1 <br /> ONT2f 1AailAddress Clry State/Zip Phone <br /> � � <br /> ���lf �7:1�I�`!i ��>� <br /> 7enant MailAddress ciry Sta�erzio Pnone <br /> �-c'+�� Zr�N�.�n�Y_ CC�'��'Inic_ ��ICZJ N�..� jC�..�1. � Iln lJ��ILL � W�� �o'll� ir'�5�9�7�G1 <br /> EleclricalConiractor MailAddress Ciry Slate/Zip Phone <br /> Fovi.�c:�ol��c�r d��t � ��, <br /> State License Number Conlract Price of Work <br /> Proposed Use of Building Conlad Person (Plan Review) <br /> Description ol Wark to Be Done: �� '.-� '��� �y'n�G��\ �-��it NL��tiYUGIy_. r�r.�.;L <br /> NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE �/" IG� �-� <br /> CITY OF EVERETT LOCAL SALES TAX CQDE IS J105 <br /> 1 hereby certdy fHat I havo ioad and oAan;mod Ihis app6cation andlrno�v the same to be Irue and <br /> co�recL All piovisions o/la�ti�s and ordi��ances govemmg fhis typo ol�vork will 6e completed <br /> �vhelher speciliod horein or nof. The granf�ng ol a pennd does not resume lo give aufhonty to <br /> violafo or cancel the provisions ol any other stato or local law reguPhng constiuctwn or the <br /> peAormance ol construc(ion. T6at I am authorized by fhe nwner o/this property to pedorm the <br /> work lor wh�ch applicafion is made and 1 compty�tivth fhe Stafe Contrac(ors Law 1827 RCW and <br /> 296 200 b'AC. <br /> � <br /> l ��5�� � ' %�.���l) <br /> ,—� na1n;B� Date —7 J <br /> . � <br /> i <br />