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a , <br /> ELECTR�CAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-f1857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I I �%E��� �{wY �``� � (Eh <br /> PROJECT ADDRESS <br /> L.tvC� A 'F I�E'�Cf'"i"(�S EU�R�ITL[� <br /> !p'ZG N ���Al�� �3�V17, �-L t,qLt=, G�a 912�� 3 <br /> OWnef . Man AdCress City StatelZip P�one <br /> �'L� ��l r��l ��Y a� ����� �,���r �A ��y <br /> Tenant Mail Address Ciry State2ip Phone <br /> ( �-�-���� ���--` 5�f� 1�NDSI� (Z1CL)`l4 ut�1 �E'.NS� �4Z.5 Cc� <br /> Eledrical Contredor Mail Address ciry state2ip Phone <br /> �'.c:�P�s���� MU __ `�i� <br /> State License Number Contrad Price of Work <br /> G�-l� C�� ��ti� `� t, )i�L���s <br /> Prvposed Use of Building Contact Person (Plan Review) <br /> Description of V�'ork to Be Done: Y'"�-t� �--��� N���-v ��""" <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 3106 <br /> I hereby certi/y that I have read and exemined this appliration and Wiaw fhe same to be true and <br /> conect. All p�ovisions ollaws and ordinances goveming this fype o/work will be camplefed <br /> whefher specified herein or not. The granting ol a peimd does nof presume fo give authoriry to <br /> violafe or cancel fhe provisions of any other state or local law regulating construdion or fhe <br /> performance o(construdion. That 1 am autFwrized by fhe owner o/this property to peAorm fhe <br /> work/or which application is made and 1 compty with fhe Sfate Confracfors Law 18.27 RCW and <br /> &&2Q0 WAC. J <br /> 1 � <br /> l , —�-� �— � � '�� <br /> Signa�ure Dale <br /> �C1� f C�'Ct7"1 <br />