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7 - �6 -v,� <br /> ELECTRICAL PERMIT APPLICATION <br /> CIT'f OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETI', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /��c•r r � � LHnc �, 1�� f�. �'locr n�: ver rw�.,� J"�o �R� �S/� � z7� � Col�� �1�., �wr•� 9r,..E <br /> PROJECT AD RESS <br /> Sl�of do I /1«I C+��e 2�v'7 (�,Il� a�� Ewrct�' W9 ry$iv6 , <br /> OwflCf MailAddress J Ciry Stale2ip Fhone <br /> Tenant MOiI Address City Slale2ip Phone <br /> �� � F���.sh., Cla + �r.� SOnS 3�'1D HvE S Sc'Nt1lC- G.�q S,4"! iY zcL�1k) -3i11 <br /> EleCtrical Contr lot A1ail Address City StatelLip Phone <br /> �-1 �KiNr� `)S;� Kcy 3 , Sor _ <br /> Stale License Number Contract Pnce of Wortc <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descnption af Work lo Be Done: /"r�t:�'� �)�' P/Q t yt ai-�/ �t�' �i^)-���'� /i D. �{ �� � _ <br /> � 11'�1�� T� � )� /� � �� S�K��t � 0 TCnn♦ [ .C+,.1� '/ •-`T � � <L�•r �' C�.i�l.r.�•{ _ <br /> 4 �� �(r �-1iN(ti� I U.tl r' �\![1 bf� N c • �C�• / I 4]J �t���c'�7 \ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERCTT LOCAL SALES TAX CODE IS 3105 <br /> 1 heraby certi(y that I havo read and examined this application and know the samo to be tnie and <br /> canocL All pmvisions o/laws and ordinances goveming(his t}�po of�vork will bd completed <br /> w6etherspeci(ied heroin ornoL Tho granting o/a pemut does nof resumo to give authontyto <br /> violato or cancel the provisions ol any other state cr local law ieguPating construcnon or the <br /> peNormanco of construction. 7hat 1 am autBonzed by the owner o!fhis properfy fo pedomr fhe <br /> work lor which application is mado and I comply with fho Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��n.�.!% /'. �.�;� � �i 9�: .•� 6 I C��J <br /> Signature Date � <br /> I ..I � <br /> l I <br /> � �. <br />