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ELECTRICAL PERMIT APPLICAT(ON <br /> CITY OF EVERETT F'ERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8$10 - FAX 425-257-8857—www.averettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �cr� S� � �,�, ,�i tifuil r���� ��,'!� 3a� �.U���N ��u�a _ <br /> PROJECT ADDRESS <br /> ���1��,-�s �n�n�nr,�,'�,,,2/ iCc'o � FUcve(f A.ln i(�ik<<� �Vev�fl� d4.k-� '4ZS �30.i '7Z2� <br /> Owner Mail Address Ci� State/Zip�KZU�y" Phone <br /> � z�'rn 5�,����,�4 �'rc�<<�, jo . � � v �Ifilfa/I ll/Gu �✓rvetl 1,U9 Su�e 301 <br /> Tenant --r Mail Address Ciry� Stale2ip�$Z(j S Phone <br /> .Sl� i� ��ull��, ����� - ;I-�, �l�l/�%� y„�n��� l�l .�1=. I�(c�'��t��ve 9��I_ <br /> ElednCaiConira or -�MailAddress City State2ipc�%% �G Phone {� <br /> � %l 7r7� <br /> S�.�J_la �:S��13T1 <br /> State License Number Ccntrect Price of Work <br /> Proposed Use of Building Contact Person (P;�n Review) <br /> Descnplion of Work lo Be Done: L�l,� �/0 I 1 `�9 � ��"���5� � � �j- 1 G'•'^ <br /> L � l� � L� ��QS — <br /> I <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 /> I hereby certi/y thaf I have road and examined this applicafion and know tho same fo bo true ind <br /> correct. A!1 provisions ollaws and oidinancos govemmg this type o(work will be complated <br /> whe(her specdietl herein or not The granting of a permd tloes nof�resume to give 2uthcnry to <br /> violate or cancel fhe provisions of any other state or locaf law regu a(ing conshuction or fhe <br /> pedormance o(consfrucfion. Thaf 1 am auLhonzed by fhe owner o/fhis property to peAorm fhe <br /> work/or which application is made and I comply with the Stata Contrac(ors Law 1827 RCW and <br /> i 296200 WAC. <br /> i <br /> ��y��,�K� I 1,�� �;� i � ' � �'- � U � S', ��,k <br /> ignawre �ate ��� <br /> V� <br />