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t <br /> E�ECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32Q0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM //y� /D <br /> L-io��-/66 <br /> S"6 l S �u���e�e� wu.y <br /> F�ROJECT ADDRESS <br /> �J �1�c��ey �o�,� P�, �vo! �qk �u,r,�o(" W� `�82�77 <br /> Owne� MailAddress City State2ip Phone <br /> �v�����,� ��� SG( S Eu.�r�r��. w uy C�-cr� w�- <br /> Te.nant Mail Address Cil SlalelZip �,y2y�3_Phu�e <br /> �S <br /> (���e��e� s� �� 26v� NwY q`( s��� 1/l�a�lU-v-ua�� � �t�2�3 <br /> Eledrical Con�racto�� Mail Address City Slate2ip Phone <br /> �-e.(-.eJ— 5 �� (2.� y — <br /> Stale License Number Contract Price of Work <br /> ��,,,. K l3�'�� LY�,C �1 <br /> Proposed Use ot Building Contacl Person (Plan Review) <br /> Description oi Work to Be Done: (k5� f� �"'��� �� `�5 G`� Y 'e(�c�'e ` <br /> �c.��'t' S��'Q�. <br /> L� <br /> �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat 1 have read and examined this applicafion and know fhe same(o be We and ! �\ �r -�1,:(�- <br /> correct. .411 provisions oflaws and ordinances goveming fhis fype ol work will be comp/eted 1 � L <br /> whether speci(ed herein or not The granting o/a permd does nof resume to give aufhonty fo (�' <br /> viola(oorcancolthe pravisionsolanyolhQrsfateor/ocallaw�aguPfingconsWctionorthe <br /> pedormance oI constn�clion. Thaf I am authonzed by fhe owner o/this property fo pedorm Ihe <br /> work Ior which applicalion is made and I comply wifh fhe Stato Contractors Law 18.27 RCW and <br /> 296200 WAC. <br /> _ �-�-�`�/� �v - z�-i d <br /> Signalure Date <br />