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i _ <br /> EI..ECTRICAL PERMlT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 Q�-�—/D <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org ��� �,_��> <br /> / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i_S�I 3 �/OU L'�4�� 75` ,Qd. <br /> PROJECT ADDRESS <br /> �rt� c�P'r Lr:�wi�7T� <br /> Owner Mail Address City Stale2lp Phone <br /> G�%�� /h" �'��1-/Ip�- <br /> Tenanl Mail Address City Slate/Zip Phone <br /> G�l+`-Ci r�f� Z-!•�C/c // <br /> Eleclrical ontractor Mail Address Cily Slale2ip Phone <br /> II,�/�� DL 9af�.�/r- <br /> ����/�J�_ <br /> State Ucense Number � Contract Price of Work <br /> _ �c'!.t//T �%LlnOi n l 'rR�//�-s� //,r✓r.(�/�/i�/�.�ti! . . <br /> Proposed Uso of Building ' Contact Person (Plan Roview) <br /> Descriplion of�Nork to 13o Dono: ��ess✓ L/�r.�r��•r��w � Jo✓/�i�-�' ( ��ci !1/'er� <br /> H <br /> �� IG-(i -iC) : -r�� �al� .C.wrcnu„ �1nD�c p��n�ra �i 7SdG' <br /> T ���— <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 3505 <br /> 1 here6y rertily that I have read and exnmined fhis applic��fion and know fhe samo to be(rue and <br /> correct. All prvvisions olla�vs and adinmices goveming fhis type oI work will bo complefed ? �, <br /> tvhefher specified herein or noL The granfinc�of a I�omuf does not pmstnno to give aufhonty fo y-�.y '/ <br /> violafe or cancel fho prnvisiau oI any other sfafo or local law regulating construcfion or the <br /> peifomiance of cons(ruction. That 1 am authoiized by the mrner ol this property to pedonn the <br /> �voni tor which applicafion is maJo and I comply wifh tho Slafe Confractors Law 18.27 RCW and <br /> 29C:.200 WAC. <br /> � <br /> ���:���yz_� �'�— l� <br /> �- Si�nalure Dale <br />