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�� . � , <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERtTT, WA 98201 � _1� � I� <br /> 425-257-8810 - FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARF ACCEPTED FROM 8 AM TO 4 P�VI G`�I O Y��� <br /> �C'� �i l Z �— �E lL� 2-NN�s-t. ( C.�[� <br /> PROJECT ADDR=S5 <br /> .5/,�vu�1 �'�Ip��f �t,�e�u�l (,ua- <br /> Owner Mail Address Clly State/Zip Phone <br /> ',j A v�N/H.h }/,r� �s �1/en,att f,v��. <br /> Tenant Mail Address City Stat:/Zip Phone <br /> �/Z$_ <br /> �pTv; S�s,�. ; `�0� ` 139nG S F' lv�� zc c2.ee� l,ua 9�a�z So��6vY7 <br /> Electrical Contractor Mail Address Gity State2tp Phone <br /> Co <br /> NFor� s�� d66 �e — ��d — <br /> State License Number Conlract Price of Work <br /> -TZ�I-l� Lveiss _ <br /> Proposed Use of Building �ontact Person (Plan Review) <br /> DescriptionofWorkto �oDone: ZNS-�+9LC PXte12/a7L 5���h �cewnv F_�i� <br /> .�. <br /> P�� �ie,Fs 0 TS �IeK. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �. u�f - U�� <br /> 1 hereby certily that 1 have read and examined this application and know the same to be true and � << � <br /> correct. All provisions o(/aws and ordinances govemrng this type ol work wi116e completed <br /> whether specified herein or not. The granting of a permit does nof�resume to glve au(hority to <br /> violafe or cancel tlie provisions of any other stat8 or local law regulofing construction or the <br /> perlormance oI constructlon. That I am authorized by the owner of this�roperty to perform the <br /> work/or�vhich applkafion!s made and 1 comply with the Sfate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,J-e• `� l q- I ( <br /> S gnature Dale <br /> L� <br />