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I ' <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMfT SERVICES 7/-� I�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org C`I��_(CJ5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �s z S Gv�2r�tz� w�a�l <br /> PROJECT ADDRESS <br /> t-n ' .�,, C�U1��- ���h- �1, wA�� Zs�- o� 2'S rZ3 <br /> Owner Mail Address <br /> City Stale/Zlp Phone <br /> 7• <br /> ��� Ls u ti <br /> Tenant Mail Address <br /> Cily Slate/Zip Phor,e <br /> 0 I. � C��1'U � Lh-kcwonlD w�9-� `f��s� Z38-azS� <br /> ElecUicalContraclor MailAddress <br /> City Slale2ip Phone <br /> � g45nn.g 3S�o. oa <br /> ����T � Contract Price of Work <br /> Slale License Number <br /> ,.q}— Drr�o Cov,�T i�c-.�G�C.7, <br /> �S�Q�V�4✓�. `1 Conlact Person (Plan Review) <br /> Proposed Use of Building <br /> DescripUon of Work lo Be Done: ���.0 � �`-+'1''"� ���'� ' " - ^ ` `� ' ��'S <br /> � <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 3705 <br /> 1 hereby certily Ihat I have read and examined fhis application and know the same to 6e fruo and <br /> correct. All provislons ollaws and ordinances govoming this fype of work will bo completed <br /> whether specified lierein or not. The granfing o/a pemut does nof resume to give authonty to <br /> violafeorcancelthe provlsionso/anyofhersfateorlocallawrepuPtingconsWctionorthe <br /> perfom�anco ol construction. That I am aufhonzed by fhe owner of Ihis�roperty to peAonn Ihe <br /> work Ior whicb applicatlon is made and I comply wifh(ho Stafe Contracfors Law 18.27 RC W and <br /> 296.200 WAC. <br /> � � Z� J1 <br /> Signalur ate <br /> � 11� 7- 155 <br />