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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES g _,3-�R <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C �p�7_10� <br /> 425-257-8810 - FAX 425-257-8857 -www.everett�va.org <br /> -, <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �;� <br /> (_7 � F✓���' I�n�-, (�Jt�, <br /> PROJECT ADDRESS V <br /> S� �?�� S���r_ ill. � 3��"7 £ v��cifP�..,,W�.�, f_'Ul� y�S� 7�o 35 y <br /> Ownef Mafl Addrass City Slate/Zip Pbone <br /> � ��-1�C'+� f��U��'e �/ l�G�,��g S�c.'c� I( 7 <br /> Tenanl Mail Address Cily Stale2ip Phone <br /> Y�{'Sc'r✓C.���(/lii C_ /Y�� . /�7�(� d /�/'" �'�-./�/i..l .J'1G""'I,JOOc� GJ� �O ✓��- <br /> Electricai Contraclor Mail Address Cily S�ale/Zip Phone <br /> C���F�� �%� 3 J�. �-� <br /> lale Liconse Number Conlrecl Price of Work <br /> V, �` �v� ,J <br /> L��,..2 C'.e <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> DescriptionofWorktol3eDone: ��,-� c� � L^� ��Ui�-S (_�1Gw�h� G� �er�,/ SIJi {(� - <br /> �G�("c���-�-�, � C.�-, cl �-�� � �`'_ � G U�/�t S, <br /> NOTE: WIRING IN NON-DWELL�NGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 �jL�p " I O 0 <br /> I hereby certi(y that 1 have read and examined this applicafion and know tho same to be true and <br /> correcL All provisions ollaws and ordinances c�overning fhis fype o(work will be completed <br /> whefher specified herein or noL The granting o/a pornut does nof resume to give aulhonty fo <br /> viola(e orcancel the provisions o/any other stafe or local law reguPting construction or the <br /> perfomianco o(constnicfion. That 1 am authonzed by the owner o(this property to pedorrn fhe <br /> work for which applicefion is ntode and 1 compty wifh tho Sfate Contractors Law 18.27 RCW and <br /> 296.200 WqC. , <br /> �:_.—--�_� —� �)�� -�`/ (..�� . <br /> _ ._ <br /> � Sic�nature Dale <br />