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1 - � � � ob <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-25 i-8857 —v,nvw.e�ierettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AN� TO 4 PM <br /> r,l `'j �,� � C� �- �3 Y S� �t ��� � ... c <br /> PROJECT ADDRESS <br /> Owner Mail Address City Stale/Zip Phone <br /> Ldwl�-�D ��NGS .�-ru��sr� �N� i 1 <br /> Tenanl Mail Address City Slate2ip Phone <br /> 1,, l�11�1�I ti'CG �LCC:T�2/C l D � — / �f� �/�(:fcJ /-�i+��✓�v0�� Gi/�f <br /> Electrical Conlraclor Mall Address Clly Sfate/Zlp Phone <br /> � 7 r / !J� /� <br /> ����C Q (�' ��� J�7�CJo ' �-'U <br /> Statn Licensa Number Contracl Price o(Work <br /> ��.t'1f'!?/J�J�/'G/�'�. <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriplian c'JJork to De Done: /�t%�N J�Z���Ly �Z, /\ (-�(�G�'/�C-�-E s l2�) <br /> NOTE: WIRING IN NON-DWELUNGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 hereby certily fh�t 1 have read and examined this application and know fbe same fo be troo and I <br /> correcL All provisions ollaws and ordinnnces goveming fhis type of�vork will be complefed <br /> whefl er speafied herein or noL The�ranfing o/a pem�R does not pres�m�e to give aufhonty to i <br /> violata or cancel:he provisions o/any ofher sfate or local(aw regulating wnstiucfion or ihe <br /> perfomianc ' vnsiruction. That 1 am authorized by the owner o(fhis property to pedomi the <br /> work lo iicli ppli�alion is r�ade and 1 compty�rith the State Confracfors Le�v 18.27 RClNand <br /> 29G. WAC. � / <br /> � � G ����E�' U /�-a,6 n <br /> Sign ure Dale C! ,�( I <br /> I � � <br /> (C� . <br /> L• <br />