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^- <br />E�E��TRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-885? - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />1 � 3 � vr�� � i;'e� �v�e.rell- ��'� <br />PROJECT ADDRESS <br />�� � J �� �� <br />�Z_3o-o5 <br />C-0512_IS�o <br />c ' <br />�n�,��,� tilul�u�ou d 133�� G2 ��� SE �Ue��c�L� w.A ��ig�� ��%5 3�8- �°'� U <br />Owner Mail Address City Stale/Zip Phone <br />Tenant <br />Mal! Address <br />City <br />State/Zip <br />Phone <br />ti�DE Flcr�,�<<.1 (��,�����cJvr 2�637 l02 (lL S� If�►1t wA �So�?� ��� <br />Electrical Conlraclor Mail Address City Stale2ip Phone <br />20� 21g-�,6n5 <br />e- �m <br />n.��Lz�v�C O�r ��� <br />Slale License Number <br />r��,,�. r ���:;t _ <br />Proposed Use af Building <br />4�-� �,Z%>a <br />Conlracl Price of Work <br />.�Ct L`t�� ,b�a�.�tJ�C� <br />Contacl Person (Plan Review) <br />Oescription ot Work to Be Dane: �F� S 1 't ����{`'� c OLc �� C��� ��J i � ��ic' j t� �t( f <br />\,u � �C VSL <br />NOTF: WIRING IN NON•DWEI.LINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVER[TT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhat ! have read and examined this application and know the same to be 6ue and <br />correct All provisions o/ iaws and ordinances governmg this lype o( woik will be completed <br />whefher speafied herein or noL The granting o/ a pernul does not resume fo give authoriry lo <br />v�elate or cancel Oic provisions o/ any other stafe or local law repuPting constnicfion or Ihe <br />pen'onnance o� sonsfruction. That I am aufhonzed by fhe owner ol fhis property fo peAonn the <br />work lor �vhich applrcalion is made and I compty wifh the Slafe Centractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />`� J�L - :,�-� <br />\`J � J <br />