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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.�rg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TG 4 PM <br /> `� ► z-� <br /> ��� �;,�,������� ,� � - t� �i �a-a 3 <br /> PROJECT ADDRESS <br /> �1, ,� �� S,A-w,� __ <br /> Owner Mall Address City SlalelZip Phone <br /> �U.1rMn L� " �'1,1n`e <br /> Tenant Mail address City s�ale2ip Phone <br /> �h/1 � Cc� rP , ?_ z�7 ✓� 5T �J�__�� J� • ��_Z <br /> Eleclrical Contractor�Mall Address Cily Stale/Zip Phone <br /> �1M � ��� �-�` � 34� k � � do � . �� <br /> Slate License Number Contracl Price o(Work <br /> �-,-�s t ,,.1_, �l �Q ,���-E-� � 5�-s�z-3�z <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descriplion o(Work lo�e Done: �I '1�✓ l _L dZ C v t� �o �(' �O D'C I� �C <br /> —J -olM� lie (': �.4- � \ HAl2 � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL.E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily fhat 1 have r dea end examined fhis applicafion and know fhe same to be frue and <br /> correcL All pYovisions of laws and rdinances goveming this type ol work will be complefep' <br /> whether specified herein or noL T granting o/a pemu�does not presume to give aufhonty to �n <br /> viola(e or ca�'cel fhe provisions o any other stafo or local law iagulating consfrucfion or the � � / <br /> perlormance,ol conslrucli�n�7hal/am authonzed by the owner of fhis property fo peAonn the Z L/ <br /> worlr lor whicIi appliGaflon is made and 1 compty with fhe State Contractors Law 18.27 RCW and /� � <br /> 296.200 WA6. ( <br /> � Z- ^ 5� --0 <br /> Signa r ` �` Date <br />