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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVEREI'T PERMIT SERVICES I <br /> I 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org <br /> I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ���� ����I� f J�er��.Z <br /> PROJECT ADDRESS <br /> �4�I;ac�° ��� 2131 yiq�t�qn� �re �ti.crofl WA��B�o( �ZI-��7-7ys� � <br /> Owner Mail Address City State/Zip Phone I <br /> t,la�l�;��li LL� 2132 Hiyhlyn�I AK �+s u�F �o yzt-� � <br /> �3�' i ZIZ��'�so <br /> Tenant Mail Address City State2lp Phone �� <br /> tie� ('�c�Cn�; INc . 17?0 G;I�s�n �',�. �iwm`i ����si��� 4xS-79n1,�.� <br /> ElectriCal Contractor Mail Address City State2ip Phone <br /> FPtPI ��'/� 21f���- r !o ' <br /> ��, �';0 __.. I <br /> State License Number Conlra Pnce o(Work <br /> K— �ps��en�r�a I ( IJ un��s � PoU � CRTS � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �i��1f �(�(���. �f�{- �jC�vk'('✓i��,/ �NS'fZ�(l� <br /> � <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 that I have read and examined this application and know the same to be true and <br /> correct. AN provisions o/laws and ordinances goveming this type o/work will be completed <br /> whether speci6ed here.'.�or noL The granting ol a permit does not piesume to give authonty to <br /> violate or cancel the provisions of any other state or�ocal/aw regu/atrng construcfon or the <br /> peAormance of construcLon. That I am authonzed by the owner o(th�s prepeRy '�pe�form the <br /> �ve�k for�vhich application is made and I corrypty with the State ConVacters Law r8.27 RCW and <br /> 296.200 WAC. <br /> _.� / / <br /> i � ��,�� <br /> l— _ �� ��;( <br /> Signature Date <br /> / <br /> � / ' ��ll �ll� <br /> � <br /> L� <br />