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ELECTRICAL PERMIT APPLICATl�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /,ZII�_) �li���l(i 17Vc% ���✓u'� �1�� �J �U� <br /> PROJECT ADDRE <br /> 1' i � � kc'r�Sr,a, �>���� �'�`flt��. �t�lz �✓liif-� 1�,;" cj����C�, <br /> (?l,i� l � <br /> Owner Mail Address Cily Stale2ip Phone <br /> ��(c_//L�/ <br /> Tenant Mail Address City StalelZip Phone <br /> r � <br /> '�'i�-ica L-7e�fi�c. ,li�C r-�� ,�,y Zvs� ���tiz�lr�/�'s I �//l <j�2sz ����3��� <br /> Elec rical Conlractor Mail Address Clty StalelZip Phone <br /> �,� f�L l�INL�L `�Sl /��� ��� <br /> Stale License Number Ccnlracl Price of Work <br /> l -S�(� `�7(��c/t 7 / �. (_ LLi/(1 r�'r'�,��5-�-� <br /> Proposed Use of Buildinc� Conlact Person (Plan Review) <br /> l <br /> Descriplion af Work to Be Done: � �����l�u;[�L-'1�� ��� .�L�'-��)1�1 C�f�%;.l�) (,C i <br /> � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED lJ fEE <br /> DE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ccrtify fhat/have read and examined this applicafion and know the same to 6e true and <br /> conect. All provisions olla�vs and ordinances govemmg this rype ol rvodr will be completed <br /> �rhefher specified herein or noL The granfing o/a pernuf does not presume to�ive aulhonty to <br /> violate or cancel fhe provisions ol any other stafe or loca!law�egulating construction or fho <br /> perfomtance o/construction. Thaf I am airthonzed by the owner ol this property to peAerm the <br /> �vork lor�vhich application is made and 1 comply�vith fhe Sfafe Contracfors La�v 18.27 RCW and � � <br /> zss.zoo WA�. � � <br /> ; ,, <br /> � , <br /> , - <br /> , <br /> � <br /> � � ; �'r �� � �'� � %C�/1 �z�z � -� � <br /> � Si�nature Dal � <br />