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ELCCTRICAL !PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, VVA 98201 <br /> 425-257-8810 - FAX 425-257-885�—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> (C�t� l�l;�.�. � f� •,/'�7� <br /> �i�/�'�^ l � l, ii , (.L '�,,, . l t'�<�r. r�l � 1 � vl I�'I�'� <br /> PROJECT A� � <br /> %Li7( Illiri �l 1c�r; •�/�- �c�Jd_ U(i,�/•: ;.�. //. !-/� �' j,j7/U-� ��S�,i, <br /> Owner Mail Address City State/Zip Phone <br /> ��i'l�{�il( ' � �}S/'li //`��'D �l% '�ii� Y i /[:y � C�G✓i'/'�-� ��,LI �% Y%"`/ -- <br /> Tenant 1.1ai1 Address ' �� City State/Zip Phone <br /> il �i j/r� 1 �� ��r�' /li�� f/ //�-��� ���< <����/: r ;, ,�•t lS-�b % �1-� .yic: iYSS <br /> -„ <br /> EleClrical ContfaCtof Mai�Address v City State/Zip Phone <br /> 1��1 �i-r i i-14 vtia� � �/�'`� !35 . � . <br /> State License Number Contract Price c .;ork <br /> h�Pil � ( ���•.-� �� l• � '% l - <br /> Proposed Use of Building Contact erson (Plan Review) <br /> Description of Work to Be Done: �i�,/�-r � - �l�/ � — <br /> � <br /> C' <br /> NOTE: WIRING IN IdON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily thaf 1 have read and examined this application and know fhe same lo be true and <br /> correct. All provisions o/laws and ordu�ances goveminc�this type o(work wi/l be comp/eted <br /> whether specified herein or not. The granting o/a permit does not presume fo give authority to <br /> violate or cancel the provisions ol any other state or local law regulating construcfion or fhe � <br /> peAormance of construction. That 1 am authonzed hy the owner ol this property to peAorm the I/� � <br /> ivork lor which application is made and 1 comply with the State Contractors Law 18.27 RCW and L'L/lL �.� <br /> 296.200 WAC. <br /> � <br /> � m,..x`,�/� 1�zq o:; <br /> SignaWre Dale <br /> ��y���`l / "'I <br />