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ELECT .�ICAL PERMIT APPLICATION <br /> CITY UF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �I.'4 IL'� <br /> 425-257-8810 - FAX 425-257-8857—w�,vw.everettwa.org ' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ��(n l 1 �.U�.«�e�c� l `�i, Sc� . _ <br /> PROJECT ADDRESS � <br /> \ c-�2S <br /> � ' t�0 Puz -�x � ���e� , �`r� �gz� 3 3s�-- �ss <br /> �:.�r,� <br /> Ownef Mail Address Cily S�ate2ip Phone <br /> Tenant Mail Address City SWte2iG Phone <br /> ) (' n + ^ n � 31�0 <br /> rJYk� Z"5'.eel,lrc.�1C, Q��(XZ-��� �•�x-ov� ll)A ���3 Icz� . . <br /> Elect ' al Contractor Mail Address City 0 Slate2ip Phone� � <br /> J� <br /> ' �"F Ic�1 �TKK� zs� <br /> State License Number Contracl Price of Work <br /> �.� ���e_� C'�w-�fL��-��,_ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: %.�-,s"� �� �-= � �` G��S� � "� �'<� f� ��fr 7� <br /> � �;�- /� � r ��'r�� � � r 1S� c�< k c% �. ,-, ,�� <�/c� ,-�r��� �£ < /� <br /> /, <br /> `�:i,' n �G , h-, s' c..J'�r�. . <br /> ,^ s <br /> NOTE: WIRING IN NUN-DWELLIN3S IS REQUIRED 70 �� FEE <br /> BE IN RACEWAYS, MC OP.AC CABLE. � " <br /> S� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily tfiat I have read and examined fhis application and know the same lo be true and <br /> conect. All provisions o//aws and ordinances governing this fype ol work wi/l be completed <br /> whefher speci�ed herein or noL The granfing o(a permd does not presume to give authonty to <br /> violate or cancel fhe provisions ol any ofher state or local law regulafing construction or the <br /> perlormance o/constn�ction. That 1 am authorized by the owner ol fhis property to perform the <br /> work lor which applicafion is made and 1 comply with fhe State Co.�tractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � . , <br /> / <br /> � <br /> �'/ �w����< �; ;'->�=.,,-,ti. / — ,Yc� C� c <br /> Signature Dale <br /> � p � � � <br /> b <br />