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— --i — — <br /> ELE�TRICAL PERMIT APPL�CATION <br /> CITY OF EVERETT PERMIT SEF:VlCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 -3/�-c�''j <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org E��d3-��/ <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT& CREDIT CARDS A!2E NOT ACCEPTED <br /> 1 1 �u�-1 ���, �,"�S'E- e-� 4�,��1 <br /> PROJECT ADDRESS <br /> �-«S-'�3-t 14� <br /> t�`� �\����i 1\�by . �� _�S FF �lpc�� t _l�(-1 �R �`{ <br /> `� �r - — <br /> Owner Mail Address Cify State/Zip Phone <br /> Ha5 -353 L �:,� � <br /> C�,��4 � r h ���� ����� �h�u �� s . Ev�s�-�e �a� Stn� <br /> Tenant Mail Address City Slate/Zip Phone <br /> �a5-a5� ��3 <br /> �� V c'�i V o E l�C!"�c �v�� �� d�l X L1 FS� � Lu n n� �Unr�1 l��-1 �lS�l]3�--- <br /> Electrical Contraclor Mail Address Ciry State/Zip Phone <br /> I N t�t o� E i c�5 K E. _ � '-i Ts o� . <br /> State License Number Contract Price of Woik <br /> � u v'�r-� S t't��Z��.� <br /> _�2.`L c�-�c��o,�—. -- <br /> Proposed Use of Building Contact Person (Plan Reviewl <br /> Description af'Nork to Be Done: ����4e o �� \s D �c ' Q- '' ` �� <br /> �hS'�e,s-�-� �nSn � ��1 '�� (Q l A�' r e� r,-��.•eS l.�i ! � n P Y� s�hu . <br /> J V <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY GF EVERETT LOCAL SALF.S TAX CODE IS 3105 <br /> I hereby cerlil}�ihat I have read and exarnined fhis appiicafion and know the se ne to be frue and <br /> correct. All prowsions ollaves and ordinances 9oveming this type of work will br�omp/eted <br /> whether specdied herein or not. The granting ��a perm�t does not presume�o give aufhority to <br /> violate or cancel the provisions of any other slate or local law regulating construc6on or the <br /> peAormance of construction. 1'hat f am authoirzed bv the owner o(this properiy to pedorm the <br /> v✓ork Ior which application is made and 1 compry wifh tbe Stafe Confracto�s Law 18.27 r�CW and <br /> 296.200 WAC. <br /> �� P,�� �1�� �� _ <br /> Signature Date <br /> � Ep9G3 - I`{L <br /> � <br />