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f �. <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES l <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��-" `� <br /> 425-257-8810 - FAX 425-257-8857—www.evereltwa.org � � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� � � � �i/C��i2L�C'/4/ W� ✓ J� <br /> PROJECT ADDRESS � <br /> [�1��.r' MDn/a? ���/� E✓C',�[v,orN �//l� t✓" ' T c✓/9 j� 2 U�/ <br /> OWnef MailAddress City SlatelZip Phone <br /> K/e`.✓ t�n,U,►Q �06�� EJ��i,��,i �v�.� �✓e�e,-� r.✓i9 9�s'zo�i <br /> Tenant Mail Address City SlatelZip Phone <br /> S'.!S7G'a�5 � .� �r'' �/�h.a Wyr 98 4t5 48��'3 <br /> € drical Conhacto� Mail Address City StatelZip Phoae <br /> (, � 5 ;-51� Dov ��� � 30� <br /> State License Number Contrad Price of Work <br /> ,�pNL I�Ir�L C r fj L j��iv! C O O/'�2 — <br /> Proposed Use of Buildiny Contad Person (Plan Review) <br /> Description oi Work lo Be Done: ZN �✓�/� // 3 � S T/¢� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily fhat 1 have read and examined this applicafion and know the same to be true and �D�Q������ <br /> conect. All provisions o/laws and ordinances goveming this type ol work wi116e complefed <br /> whether specified herein ornot. The granting ola perm�f does not presume to give authority fo <br /> violate or cancel the provisions o/any olher stale or local law regulating consfruction or the <br /> peAormance o(consfruction. That 1 am authorized 6y the owner o/fhis propeRy to peAorm the � n <br /> work/or which application is made and 1 comply wifh fhe Sfate Contractors Law 18.2i RCW and y� <br /> 296.200 WAC. / <br /> � <br /> � �� �,o�=�� i//6��,6 �}\ <br /> Signature Dare r <br /> l�� <br /> V <br />