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ELECTRICAL PERMIT APPI_ICATIOtV <br /> ClTY OF EVERETT P�4MIT SERVICES 5 � a. � 0 7 <br /> 3200 CEDAk STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org L--^p ��S�O/� <br /> APPLICA�'iONS ARE ACCEPTED FROM S AM TO 4 PM <br /> (r121 � � �.'c��_C ti�z.�' (�.�}y ��,�y <br /> PROJECT ADDRESS <br /> Ownef M11ail Address Cily State/Zip Phone <br /> y�S <br /> �UI [ IC �� �iJ'� ����Z/ �.✓c7��..=EC.Iu ��.�"�/ L`�/cC�t`�� �ti':� �'�26�/ �ic" 7,i��/ <br /> i <br /> Tenant tdail Address Cily Slate2ip Phone <br /> — yzr- <br /> 13G� �l�>U Si�2Ultt" /��/1 ��:i71• N'd:. /h�.�.F,1z,�) /'//�[ C.�'t2�c' l��f ��/? 5 s�- d'i6� <br /> , <br /> Elecirical Contrac;or Mail Address Cily S�atelZip Phone <br /> f;�;'js�t,c,�"�9.,r�� '�5'� `— <br /> State License Number Conlract Price of Work <br /> iZt'�I�_ f� h.,�� �2� �3U �/6� <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Descriplion oi Wark to Be Done: }.U��1Zc_ ��,L'� C}r�� N�-�-- Lt�����- �71����Jl-=y �✓ ��U�/< <br /> l, � ��l C `�IS�/�,Ll_ ;`�Y.C;��L <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B� IN RACEWAY'i, MC OR AC CABLE. <br /> i <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby certily that I have read and examined fhrs application and know the same to be true and <br /> correcL All prov�sions o/laws and ordinances�overning this type o(work a�ill be completed <br /> whether specified berein ornoL The granting o(a pernu(does not resume to give aufhonty fo <br /> violate or cancel fhe provisions o(any ofher state er local law reguPting construc6on or the <br /> performan:e of construchon. That 1 am authorized by fhe owner o(fh�s properly to pe�Iorm the <br /> work Ior which application is made and 1 comply�vith the Sfate Contractors Law 18.27 RCW and <br /> � 296.200 WAC. ��" <br /> i <br /> i r." <br /> / � �;/�� /���d� <br /> Si r2 Date <br /> j o,o s-ar°t <br />