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► � . <br /> , <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 3E201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org � `"��-� � <br /> APP�.iCATIONS ARE ACCEPTED FROM 8 AM TO4 PM C=O 7� —��y <br /> �fQ,) 1 � <br /> - ��./.� �i�kE rs ,'I r/� ! '7��l <br /> PROJECT ADDRESS <br /> //�l�.IN���I )h�� �d�N15 /�6<i C °7�T� d.�c��� Euc 65T l�A � �l �'�U SLJ <br /> O�e� Mail Addrass City SIa�e2ip p��o� <br /> Tenant Mail Address <br /> City Slate2iP p�� <br /> ti%��6i��scfK�� ��S�eK-� � �ac�P,e��.�a�� d� � ,,�sr� �✓� l i2o3 s��S:��I yU� <br /> Eledrical Con actor Mail Address / �ty Statemp Phona <br /> ��G `L��C I�II � � �SnO �J <br /> State License Number Contract Price of Work <br /> �Erai�. <br /> Proposed Use ol Bui�ding Contact Person (P�an Review) <br /> Description of�Vork lo Be Done: �b �(,b G� I /{'16 T6/2 � l/a/J 6(� � �/JS r�`(� <br /> �,��;a�� �'1 cT�n d- 2 /2 5,� ,.�„ ��NtLs <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVER�TT LOCAL SALES TAK CODE IS 3105 <br /> I hereby ceRify fhat I have read anc'e:•amined this application and know the same to be frue and <br /> conecL All pmvisicns o(/aws and�roinances govemmg�his type ol work will be completed <br /> whefher specdied herein or nof. he granting ola pem�rt does nofp resume fo give authonty fo <br /> violate or cancel fhe provisions o%any other sfafe or Iecal law regulating cons(ruchon or(he <br /> peAcmrance o/con;lrvc6on. ?haf I am aufhonzed by N7e oWner ol this property to peAom:the <br /> work lor which appncalion is made and l ca'mply wiM fh$SYafe Contracfors Law 18.27 RCW and <br /> 296.200WAC.^;" .../ ,-� /�' <br /> 'i i <br /> i <br /> ��� .�!' . ���/, i <br /> � ��.i-r� /� l%,i, �� � <br /> , Signature • . D�le <br /> Ec�a�-l7�{ <br />