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`l - a� — c.�: <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.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���ir� l �,���Y. f'121C ��.. ��� <br /> PROJECT ADDRESS <br /> C_C�Ui�.y�i' �^>!.�-�' � <br /> OWnef Mail Addmss City Slale/Zip Phone <br /> � �i�� �s/ � \,���In�2 � r"���r� � ��OC � W rt 1 cQ�� <br /> Tenanl Mail Address City StateZp Phone <br /> �--���c.��. C.�-��.� L�s— _�Z��7 1�- I�+r_ � t� v.�� 9gisy z�zs74�c�A <br /> Elec ical Q�ontraclor Mail Address ily �� Stale2ip Phone <br /> 1 � <br /> ._!I_ (-,;�{,��{-G'O S`r �r�cLw�..�cx �- r! ((VV���[ I �d�i 71�-�" <br /> Slaie License Nurnber �`y U Contract Pdce of Work <br /> I �) <br /> Preposed Use o(13uildinc� Conlacl Person (P�an Review) <br /> I Descriplion oi Work lo�e Dono: ���c�� '�"'.x ��llµ-f <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf I have read and examined this applicafion and know fhe same to be We and <br /> correcC All provisions o/la�ss and ordinances gove+ning fhis lype oI rvork will be completed <br /> whefher speciGed herein or not The gr�nfing o/a pemuf does not reswne fo give authonty to <br /> vielafe or cancel fhe provisions oI any other state or local law reguPling construcf�on or the <br /> perlomiance ol consfruction. Thaf 1 am aufhonzed by fho owner o/fhis property to pedomi Ihe <br /> work lor which application is rnade and 1 comply wifh Ihe Sfefe Contracrors Law i8.27 RCW and <br /> 29ti.200 WAC. <br /> � � <br /> ��� � , <br /> !i , (/ �'�_ �>,-, .�_.t _, '''! ob <br /> ' Siyn�ttfre � / Data � <br /> �oico� - 11 2— <br />