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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org I � � 7 -0 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �v 70 ! -D�U <br /> ' � � 32 �v���,r-e.e,� l-Jr� � Sw� �e fJ <br /> PROJECT ADDRESS <br /> � ����r�pn (Zo�;� I LLL <br /> Owner Mail Address Ciry State/Zip Phone <br /> Tenant Mail Address City Stale2lp Phone <br /> � PS� ��P���'iL l`/D�S� h9"'� l9UC--S� SiUbNOrll(Sy Lt/�" 5�2�1i� �6-67�-761 <br /> Electrical Contraclor Mail Address City State2ip Phone <br /> Q�sT�G-����m �-- �� 3voD <br /> State License Number � Conlract Price of Work <br /> 4� 7P;�y��k� <br /> Propos�Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: �Uli 1��f) W�P� �� I�i'"�C!^P/j Qr!/Ai/JYIJ(�I� �. ��J�/1�iQQ <br /> (� � �{ -I /� ' 'T /�7 /, <br /> �'�� ctz3 t 0 I U U U S �1 S �l'?� C�il�i�:� 1�/'P S'G���5��U i'1, l/�oti/�GCfL <br /> 4;c7 w� � ��� s�,u �1 .. <br /> 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 liereby ceitily thaf 1 have read and examined this application and know fhe same fo 6e true and <br /> correct. A/l provisions of laws and ordinances governing fhis fype ol work will 6e completed <br /> whefher specified herein or not The granfing o/a permit does not presume to give authodty to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> perlormance ol construction. That 1 am authorized by fhe owner o(tiiis property to peAorm the <br /> work/or which application is made and 1 comply witti the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. ,., � <br /> ,}��� � . �-/�-C� �j- ^ , I o� <br /> �$ignature Date ✓ ' � <br />