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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820'I <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> -_ � O j /,L /�'1 5"T <br /> PROJECT ADURESS <br /> ��.EtN T��-OM�7Son/ '5��0.3 C�Ci�7� Si� t"G'�'.e.c,.�.Y (nlA y7.�'S1,jg� <br /> Owner Mail Address City State2ip Phonc <br /> Tenant Mail Address Cily Slate2ip Phone <br /> NFi2t3ova ��rtiT £Lc'c7z�c Tv � Gy a S /65.�, sT Sr,.� ,C�.vw�✓cor� c�� �"1�o�� ��75-7yZ -7z 6 <br /> EleclriCal Cuntractor Mail Address Ciry State2ip Phone <br /> 1�N2}3i+Pf: �3l• y �P / 700, o�> <br /> Slate License Number CoNracl Price of Work <br /> 5. �, K STAnI 61zw�cE2 <br /> Proposed Use of Building Contact Person (Pian Reviow) <br /> Description of Work lo Be Done: ✓✓�L✓ Z ��o ii ��t p �A�c t. /,TNyi R L C.. � �c'r•sS <br /> �aNs „�' L ,.,n,�i IZ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have read and examined this application and know fhe same to Ge true and <br /> correcL All provisions ol la�vs and ordinances govemmg fhis lype ol�vork will be completed <br /> whefher specil�ed herein or not The granfing ol a pernuf does nof presume lo�ive aufhority to <br /> violate or cancel the provisions ol any olher sfate or local la�v regu/ating consWction or the <br /> performance of conslruction. Thaf I am authonzed by the o�wier o/this property lo perlomi the <br /> work lor which application is made and 1 comply wilh(he Sfafe Confractors La�v 18.27 RCIh�and <br /> 296.200 WAC. <br /> �J��° � ^ /,, �� <br /> ( . � <br /> �K!/`L�L � �.`'v✓V , 1' , <br /> Signature Date i I <br /> � <br /> ��� <br />