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/ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE:, � _ , g�o7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org G 07U�—I1� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ;l6 3� `C��r�r�h ��l 5u�.o�N 2�erQ� U,9o, <br /> PROJECT ADDRESS <br /> Owllef Mail Address City Stale/Zip Phone <br /> � ��CfP D�a Cv' l/�3 �- >J�,,(�P_, c,.f�� �'u, ���{ ���YP � �v� <br /> Tenant Mail Address � � City Sta;elZip Phone <br /> �� �lPr�`r, Cd /�{l's� ���' �i1,P. �'�, S.�bl�0/�%f'�i � � pi'� 6 <br /> Eleclrical Contraclor ldail Address Ciry Statr.iZip Phone <br /> ��ST�C,k o 7 OM 7 � ��, <br /> State License Number Contracl Price of Work <br /> ( .0�mo/'�--�� Cf�f-1 �-P-P <br /> Proposed Use of Building Contact Person (Plan Review) <br /> /^/ """���,ccc��, /� � /�` <br /> Descripticn of Work ta Be Done: � � ,(1�/SG�X�lr v�� /�)P�����!U/� f�^7 <br /> � D <br /> �d-ov�c��t U�-�4%/ � �' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TQ FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and examined this application and know ihe same to 6e Vue and n1 G�� _�`I <br /> correct. All provisions ollaws and ordinances govem�ng this type o!work will be completec� E V � <br /> whether specified herein or not The granting of a perrtut does not resume to glve authonty to <br /> violafe or cancel the�rovisions o/any other sta(e or local law reguPting construction �r the <br /> performance ol construction. That I am authorized 6y the owner o/this property to perlorm the <br /> work Ior which application is made and 1 comply with fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> <"' �e -1-/ � -Q -] <br /> ---r,.� <br /> Si�nature ` Dale <br />