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ELECTRICAL PERMIT APPLI�ATION <br /> CITI' OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREl-f, WA 98201 <br /> 425-257-881G - FAX425-257-8857 —www.everettwa.org <br /> APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> j ����J ��"'% �/r��, �� =j ��„ � � <br /> PROJECT ADDRESS <br /> � : <br /> �. � / i�` .� <br /> �/�„� ��� � ��%l / 73 /`i �� ' �`�/�,��,1./s �L�� �i,s�� =�� <br /> Owner Mail Address Cily Slate2ip yz�_ 7p o e <br /> �'3-z s- � <br /> �°� i 1 ( . <br /> Tena�t Mail Address Cily State/Zip Phone <br /> L, . �� <br /> C;�,i:�ri J��S '/ ��'rG Jll'/ Le.'c ti�/,�4' Le�`�t7 LL'�'J %53�-/ �J�2 '1�i Z��•� <br /> EleclriCal ConlraClor Mail Address City Stale/Zip Phone <br /> t f"�L ��L'-i : /`fz_ /- � ��^n�� `=- <br /> Slate License Number Contrecl Price of Work <br /> �;irMe. � - 'e I <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description o(Work la 6e Dono: ^"f /I �" /C�� /(' L�. 7�� ��'� r � <br /> NOTE: WIRING IN NOIJ-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !here6y certily that I have read and examined fhis application and know the same to be true and <br /> conect. All provisions o(laws and ordinances goveming this type o/�vork will be comple(ed <br /> whether specified herein or not. The granting ol a pernut does not presume to give authonty to <br /> violate or cancel fhe provisions oI any other state or local law re�ulating construc6on or the <br /> perlormance of consfrucfion. That 1 am aulhonzed by fhe owner oRhis p�operty(o per/onn fhe <br /> work lor�vlrich application is made and 1 compty wifh the Stafe Contractors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> � <br /> � ///��� I <br />- ��� �";'�l�'. ��/��r y- z .�- � � <br /> Signalure � Dale /�/,� � <br /> �v /I <br />