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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—www.everettwa.org - �`� - <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 7 2 o C�Ab �.,c <br /> PROJECT ADDRESS <br /> ��.,b�� '�'�e � �r��� \ <br /> Ownef Mail Address City 5tala/Zip Phone <br /> Tenanl MailAddress Cily State/Zip Phone <br /> �:��n��n ]� �.��..Trv��� 1�� �ZL ,�i� .[�ac Sec�'���r U'.i� 9�\2i 2Cl.i'33 SiLy <br /> Eleclncal Contracbr Mail Address City State2lp Phone <br /> I�Vf��N�-� �q\��-'� �f �S' 3ooc� <br /> Stalo Liconso Number Contract Price ol Work <br /> 0 <br /> ����A.��.n��' <br /> Proposed Use o(Building Conlacl Person (Plan Reviow) <br /> i �a,^� <br /> , �y p <br /> Descnplion of Work to Oo Done: �`�eu.; u'Yv,cc q�� �iq......1 �.,�,\� �i-����y.� e �..� <br /> - �� ! �c•—����- <br /> I \ 11� 1` <br /> C'c�c-�V-�� � (;�-.'t`�Ts. C�w.0 ��.cl._.� ������' cu—.pc.'h�� <br /> NOTC: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CAE3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> 1 hereby certily thaf I have read und examined this application and know fhe same to be frue and <br /> co�mct All pravisions o/lau�s and ordinances govemmg fh�s typo o/worlc wil!bo completed <br /> whether speaGed hemin er noL The granting o/a pernnt does nof presumo to give a�dhonty to <br /> violafe w cance/the provisions of any ofher s(afe or locol law regu/eting consfrucfion or fho <br /> per/omiance o/construction. 7ha(I ant ou0io�ized by the owner o/fhis property lo perfomi the <br /> �vork lor�ti hich applicafion is made and 1 conrpty�Nth fhe Slate Contractors Law 18.27 RCW and <br /> 296.200 IM1�AC. I <br /> .I=�=—— I b/c b'/z�oo 9 r <br /> Signalme Dale L(.�(C 'Q4�Z, <br /> C <br />