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i <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.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM (�` O�_ a� <br /> ::t�FiNF- 4� � L)`� �Lt�C> >SDI GJC,sT I�LL�Ni:. PEr'�vn�ier� I�D t��S7� <br /> PROJECT ADDRESS <br /> ��E i v� E- <br /> pwrier Mail Adtlress Ciry State/Zip Phone <br /> y'i 3 3j& <br /> 3t A�l�v�i�e _ uoc �c�R�.ne l',�.'�F-� �'f' c,.i6cun:G=i�,,�'� FL 3-�`��y �� <br /> Tenant MailAd��-ess Ciry State/Zip Phone <br /> yas-3a� x� � <br /> ('�a� l'tE�6�c Itnu��ti't�,[cC ���SL� /ao�"I'WEp1'tf3��- IGQIc�+7u�� u��h `1�a3�/ <br /> Elechical Cont�actor Mail Address Ciry State/Zip Phone <br /> C �Zr�t�'�. C i-� `i 3ci (�F 30� c;�ra�. o 0 <br /> State License Number � Contract Price of Work <br /> / �Gr+ r l�'I��uF/3�.�,�,n.'�r -- i <br /> Proposed Use of Building Contact Person (P;an Review) <br /> Description of Work to Be Done: 1� �`^��{-�� �Oi`� �F �f�/� ����f —!'�`� 5.5 _ <br /> L i'�' �-�i ��r ,z r�fl!J� Z i��r�n-� F i�t�'� nF'r�C. Z u N <br /> , <br /> NOTE: WIRING IN NUN-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certily fhaf I have read and examined this application and know the same ro be hue and <br /> correct. All provisions of laws and ordinances goveming this type ol woik will be completed <br /> whethnr specrlied herein or nof. The granting of a permrt dces notp resume to give authaify to <br /> violate or cancel[he provisions ol any other state or local law regulafing constructron or the <br /> perlormance of construchon. That 1 am authonzed by the owner o/this property to peAam the <br /> work loi wlrich applic�on is made and 1 comply wifh the State Caitracfors Law 7827 RCW and <br /> 296200�WAC. <br /> � ��1./�" `�"� �>� � I <br /> , � <br /> � Slgnature Dafe � �1 '�I � I <br /> � � I <br />