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� _ 1 - 0 (0 <br /> ELECTRICAL PERlVIlT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �\� <br /> 4�5-257-8810 - FAX 425-257-8857 —www.everettwa.org `�� <br /> P.PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/ <br /> I�oZ ( S E (�ve re l� 1`1, l�� 9'Fs�o�( <br /> PROJECT ADDRESS <br /> �ao U� <br /> or `nl 1i � /3S/'� ..9/�� ST� rto v�+is�r ��,� 9�d%/a Y�b -!dl3 <br /> Owner Mail Address City SlatelZip Phone <br /> Tenant Mail�ddress City State/Zip Phone <br /> �'.�b� <br /> �"� ,�/ ?37'87d,Z <br /> ����r 5e,� .��e�,��� yyC�g ��.,Z— � tr 1 ���,nf�,l'c, /cft�,ls._—` l/� %0�13 <br /> EleCtriCal Conlraclof Mail Address City State/Zip Phone <br /> �(S l 97/LC ��/S t�o , - <br /> Slate License Number Contracf Price of Work <br /> �����.��� ( 1Ps��cnces �sr� �ar3) ��s���a.2 <br /> Proposed Use oF Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: �� 5E'/iiri� ('r�/1G�t.rr� s '�T�/���� �� <br /> ,�Q.�k?4i.-.S r/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, �AC OR AC CABLE. <br /> � �� <br /> " CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !I <br /> � 1 hereby certily that 1 have read and examined fhis applicafion and know fhe same fc be true and <br /> correct. All provisions o(laws and ordinances governmg Ihis type o(wak will be complefed I <br /> whether speci(rad herein or noL The�ranfing o/a penmt does ncf l�resume to give auihonty to � (�� <br /> violate or cancel the provisions o(any ofher sfate orlocallaw rec�idafing construcfion or the � ��r <br /> pedormance of construcfion. That 1 am authorized by the owner ol th�s property to peAorm 1he 0 <br /> work Ior which applicafion is made and 1 comp/y�viih tha Stafe Confracfors La�v 18.27 RCW and �)„y,�. <br /> 296.200 WAC. �(%�, <br /> �/ /O C' � <br /> Signalure Dale <br /> +l�!.'C� '��J � <br /> � <br />