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EL�CTRlCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> 1��' 11�1.�ii �aS E�czfZGP-F�a.� w,� ���T c.a1v} 5'S2G� UZi-�j�F-19z� <br /> Owne� Mail Address Cily State2ip Phone <br /> .SU 1.<n4 �(�ii Z���ltc-� <br /> �x.z,al SEc.�C'.,,`�y ��S Ex���^1'i-�.i�4�1 E�l'..�u �La 9�� <br /> Tenant Mail Address City StatelZ�7 Phone <br /> /�iPiZr� ,''('j1'�Fc/�,'��cut� y��/s3'�'�N.E ���s��vx'� �c.� 9�izrt_3 5�s--��-� szz y <br /> Eleclrical Conlractor Mail Address Ciry Slate/Z�o Phone <br /> State License Number Contract Price of Work <br /> �fj'/1J,49E'LI�t?-�6zTn� uts LIUS-�4S�v <br /> Proposed Use of Buiiding Conlact Person (Plan Review) <br /> Description of Work to Be Done: �i roli A �1�,J 75`f31' t1� :-�.��.'�- S*-� (R �� L1 i`i+ _ <br /> (�ASiiNi+�_�V— ZF-,��y.9� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that 1 have read and examined fhis applicafion and know the same to 6e true and <br /> ' correcL All prqvisions o(laws and ordinances governmg fhis type o(work wi116e completed <br /> i whefher speci(ied herein or noL The granfing o(a pennd does not presume to give authority to <br /> violate or cancel the�rovisions o/any other state or local law regulafing construction or fhe <br /> peAormance o/construcfion. That I am authonzed by the owner of this property to perform fhe <br /> work!or which applicatron is made and I comply with the Sfate Centractors Law 18.27 RC W and � �� <br /> i 296.200 WAC. / � � <br /> y/ i � / / � <br /> ' ' ��-�/� "�-� / `L'�,/� � ', �I <br /> /. J/ —^- � lY l� <br /> ' Si�naWre ��" Dale <br />