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( � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �;7 %" <br /> 425-257-8810 - FAX 425-257-8857—www.evereV00UpRrg ' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> IoL-�( ��-�yrC�.�� �.«.�� <br /> PROJECT ADDRESS <br /> ����t��,�,� ( y��a �zu`� w�� ��1,�,��.,�ls ��1� 9��;�� �-ff'y-7f'�!� <br /> Ovme} Mail Address Cily StetelZip Phone <br /> `14:�'l�i �7e-��y �U�i�� �UL�c+(�C�L k."-•l� l-V�!'� �..i� � YYy-7y¢'� <br /> Tenant MailAddress Ciry State2lp Phone <br /> . <br /> , �Ec� • y?Y-r��s <br /> ��v1h/���L� � ��L�ti� ��s��l �.6oF� l��� YYs���� I��:t7���,��.ic�/� ����3 <br /> E!edriral Cont dor Me Jress CRy State/Zip Phone <br /> �� e�-c�����l��y ��"� <br /> State icense Number ConVact Price of Work <br /> Ch.( St'_C���c� I��I� �`(`� C �'l <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description of Work to Be Done: �kS�` 1 �`''�f �! CI L� <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 3106 r <br /> 1 hereby ceRily that 1 have read and examined fhis application and know fhe same to be true end C.-U������� <br /> correct. All provisions ollaws and ordinances goveming fhis type o/work will be complefed <br /> whether specified herein or not. The granting o(a permrt does nofpresume to give authonty to <br /> violate or cancel the provisions o/eny other state or local law reguleting construction or the <br /> peAormance o/construction. That I am authoiized by the owner ol this property to peAorm the <br /> work lor which application is made and 1 comply with the Sfate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 1?�-�-�(' �, ��, L I-2�-� 7 .- <br /> Signature '' Date <br />