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• I <br /> ELECTRICAL PERMiT APPLICATION <br /> CITY OF EVERETT f�ERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wwvu.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1_-�US L��a�fir�n Gt,�t.y �'� l�� <br /> PROJECTADDRESS <br /> '��� � <br /> l�l1i� � .��fflP �in0�� l5� Cv. l7'�Vi/�Iliec�X��: ���e1f 1�f/� 9��/ �579_3i <br /> Owner MailAddress City State2ip Phone <br /> ���fil�2f�lf� �,e�ve�'�I <br /> Tenant Mail Address (;ity State2ip Phone <br /> � �,/ �Q.�75-742- �y5Z <br /> /�. �ll7iir �l��fr�, �nC. �Lo/!� /����>� S l� r/���/i7�lU�'J� �� ��'CHY� <br /> ElecMral Contractar Mail Adtlress Ciry '� State2ip Phone <br /> 1�m�2r�la�3a5 ti�'C� .�� <br /> State License Number Contract Price af Work <br /> {��u�an� <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Descnption of Work to Be Done: I I P �� !�Q�l I��Q (M X// ( ���� <br /> �1'�>I(f1 �X1.STI� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, �dC OR AC CABLE. <br /> CITI'OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I heroby certily thaf 1 fravo iead ond oxamined this appbcalion and know fho same fo be frue and <br /> wrrecf. AIf provisions ollaws and ordinances govemmg fhis type oI work will bo completed <br /> �vho(hor specilied herein or noL Tho grantinr�o/a pemut does nof prosume ro give aufhonty to <br /> vio/afe or cancel tho provisrons oJany ofhor sfato or local law mgulafing consWclion or Ihe <br /> peAomiance olconslrucfion. Thaf I am aufhonzed by Ihe owner ollhis property to perform fhe <br /> work lor which application is made and I compty with fhe State Confracfors Law 18.27 RCW and <br /> 296.200/WA� C. <br /> �_ j � <br /> a� � � l�o��ir �� p� - ��3 <br /> _ Sgnature Date <br /> _.\ <br /> ' <br />