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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � ._(/ —!'J7 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org , / <br /> � o�I�--d 6�t <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / <br /> � � �� �)v <br /> ii�G> ��.����-�.N��, U <br /> -1�-r��=-I�—�-�=t—. c���;.�-�� � <br /> PROJECT ADDRESS <br /> � <br /> �b� �� oi- r��e�� 1�1 ��c•� ��s��' S1 �'ve ��e ti� w� `i�2�� � <br /> Owner A1ai1 Address Cily Slale�Zip Phone <br /> �;�,�, c,� ab�� � <br /> Tenanl Mail Address Cily StaleiZip Phonc <br /> i <br /> `�.:n�Kv1 � c � �i ' ;�.��-1 C[.l iz�c n c� Y�U� �� U z(ct f1 l� `���i�-U 1 <br /> EleCtrical CoNracfor Mail Addross City Slalc2ip Ph�nc <br /> � � ���� lt� <br /> `���NLSp-b� �i�I ��� -� � - <br /> State License Number Contract Price o(W ork <br /> Proposed Use o1 Ouilding Conlact Person (Plan Revicw) <br /> Description o(Work to Do Done: _ .1—���tCl I I �—U UJ �V 1 � i'['1f�,Q L.0\ 1 f�-{ S�I S T� Vti-�—_ <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY 0�EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y(hat 1 have read and examinod Ihis applicafion and know fhe san:e(o be We and <br /> correcf. All provisions ollaws and ordinancns 9oveming fhis lype ot work�vill be cemplefed <br /> whefli�r speci/icd herein or noL The granting ol a pernuf does not presumo fo give aufhority fo <br /> violafe or cancel fhe provisions ol any other sfate or local law regulating consfruction or fho <br /> peAormance of construction. Thnf 1 am aufhonzed by fhe owner o!Ihis propeAy fo pedorrn the <br /> work!or which applicafion is modo and 1 compty wifh fhe Stnfe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ``��l '' � � � i ��n `) � 11 � �'' 1 <br /> Signature ��� <br /> F�1c�-G��I <br />