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ii - ir —o � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERET7 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857—v�nvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � <br /> 6 L <br /> IC��? ( S E (;ve re l� h1�. �� l� 9�r�o�( <br /> PROJECT ADDRESS <br /> �ao�� <br /> � e ' � i 3 si� �i�'� sT� Sa��M;s� `,�lA 9�a9'6 voe -fai� <br /> Owner Mail Address City State2ip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> �.a�b� <br /> �1�f/tSL'✓��lP�e�fiG y9v� �,J.Z ,d� S/y/ �� A�/FG ,�j�/� �[ �fi �1043 �3�'b'7doL <br /> Elecl�ical COnUac�or Mail Address Ciry Stale2ip Phone <br /> /�QRAs� �9��L � �vs �� , <br /> State License Number Contra l Price of Work <br /> GPSc�G91i� � �PSI�QC/1C�S ��P /-f�,�<�S�n (s�O(��?�S^rF�.�� <br /> Proposed Use of Building CoNact Person (Plan Review) <br /> Description o(Work to Be Done: �� �. '�O � ^c <br /> �='�s21L-•�' -- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> � � — .e�c.� <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> 1 hereby certily fhat I have read and examined fhis applicafion and know the same to 6e true and <br /> correct. All provisions ollaws and ordinances govemm�this type oI u�ork will be comple[ed � <br /> whether specified herein or not The�ranfing o(a pennd does nof presume fo�ive authonty to � <br /> vio/ate or cancel fhe provisions of any other state or local law re�ulatin�consWction or the <br /> per/omiance o(construcfion. That 1 am aufhorized 6y the owner o!fhis propedy to peAonn fhe <br /> work lor which application is rnade and 1 compty with Ihe Sfafe Contractors La�v 18.27 RCW and <br /> 296.200 WAC. �� <br /> y io c� � <br /> Signature Date <br /> �0� ;,,.�- (.-5s <br />