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le — r7-O <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-SB10 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _-, �- , � � -�fi <br /> i; / � c� (��� 5,.�. � � / <br /> PROJECT ADDRESS <br /> CCP Gren�.c�7 U(� LLG� :'�1 � {C.�c��� � „�r��f f G-✓�� <br /> Owne� Mail Address City State/Zip Phone <br /> ��l �; f l�c�naSe�nra7 Gr:•,O � SUl �1�., ��r�;�f Cv� <br /> Tenant � Mail Address City State2�p Pnone <br /> �j �/ ; <br /> i � <br /> i' <br /> '� � /"�.. i,� ��% {'?� S� i •�'tiC� ,,�t�f ,�1.�s.oZY-�cY �Cl/,T� _��C��-(,���-J�`"�C� <br /> ElectncalContractor MailAddress City Stale2ip Phane <br /> (T.S ��� c`_! � �-S-�r-` � � � 5.�JC' c'�G— <br /> State License Number Contracl Pnce�f Work <br /> r71 � C � <br /> Proposed Use of Buildi�g Contact Person (Plan Review) <br /> Description ot Work lo Be Done: �E' �'i✓11� � ✓'�P�B ✓Z�"7f'.•I� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO fEE <br /> I BE IN RACEWAYS, A1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certiry fhaf I have read and r,xamined fhis applicafion and know fho same fo be true and <br /> correcL A/l p�ovisions ollaws and nrdinences govemmg fhis fype ol work will be complel6d <br /> whefher speci(ed herein or nof. Tho granfing ol a permd does not presume fo give aulhonty fo <br /> violafo or cancel fho provisions ol any ofher sfafo or local/a�v rogulafing constn�chon or the <br /> pedonnance of constn�ction. That 1 am au(honzed by(ho ownero/fhis prope�iy fo pedomi fhe <br /> work lor which application is made and 1 comply�vrth fhe Stata Contractors Law 1827 RCW and <br /> 296.200 WAC. <br /> � ,,, � i" - <br /> ,. , / /� -> <br /> ,�,� :, � j j��j- r. �. , <br /> Signaturo Dale <br /> �o, « -�� z <br />