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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT P'ERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982�1 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �—�O—C�' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM c �/�`�3� <br /> 5� !�, r v��c�-Rc�ti W �y <br /> PROJECT ADDRESS <br /> CArirvg �,z o�,zc�, �/d,��,.� Fo�+r�DA1-�oTl 36 �a �= ve�.y,iaeN 41�-Y �'7]�U3 - 7`=. <br /> Owner Mail Address City Stale/Zip C� Phone <br /> ��P.-�y .� !a� —�/22-.?,�'-. �. <br /> Tenant MallAddress City Stale2ip � ��❑�,�. � <br /> L/e,..�e �y..� � Ltci I���L vyiy ���-N � r4�� Evtr^�7�i,.,�+ 48c�ci3 <br /> Eleclrical ConlrBclof Mail Address Ci(y StatelZip � Phone <br /> ao�-3oy -3'97 <br /> �-�F� � E � q/ 9 O �� � �/Sc'� <br /> Slale License Number Contract Price of Work <br /> �-1 e t-r+ ; � <br /> Proposed Use of Build�ng Conlacl Person (Plan Review) <br /> Descriplion of Work ta Oo Done: ���u N� �r� a^- Cu.e<..� �� ��"' Cel�.9 t.u�. <br /> . <br /> NOT[: WIRING IN NON-DWELLINGS IS FicQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT 1 OCAL SALES TAX CO�E IS 3105 <br /> 1 here6y certily Ihaf 1 have read and examined fhis applicafion and kno�v fhe same to be frue and <br /> correct. All provisions ollaws and ordinances goveminc�fhis(ype of work w1116e compfefed <br /> whether specified herein or noL The granfing of a pormd does nof �resume fo give authonty fo <br /> ��iolafe or cancel the provisions o1 any other stafe orlocal la�v regulafing consGucfion or Ihe <br /> peNomiance of cons(rucfion. That 1 am aufhorized by the owner o/fhis�roperty lo pe�fonn the <br /> work lor which application is made and 1 comply tvifh the State Con(ractors Latv 18.27 RCW and <br /> 29G.200 WAC. <br /> ,���-�_ << � �e, - ___ ---- oy/3�/a� <br /> Sigitalure D4I��� <br /> �E v�tc��j-(3� <br />