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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> s�' <br /> I � � C �:�a_�'T ��A�i.. <br /> ��I '—� �IL�IV� � <br /> PROJECI'ADDRESS <br /> 1�C� Yl�'l A Y�'1 G 1'S hA c.1� �������� <br /> OWner Mail Address City Slat�IZip Phone <br /> Tenant A4ail Address City State/Zip P�wne <br /> N�.�-�j <br /> �L � lr(�tL� T�1�' L��7 1"0 1'�� ✓�Z. S/L.V[-t Y'1�'1, ��F S'/ � J �O ! /'3� <br /> Elecdical CoMraclOr A1all Address Cily Stale2ip Phc,ie <br /> K-u/o'i.cG � �17 ZCJ �jp�j no <br /> Slale License Number Contract Price of Work <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Description e(Work lo Qe Dono: I �'l 5 T�i.� I�- (�AQI��C �-( L'.�rC u �T FJ r <br /> S �� ✓1 <br /> 1 <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> f3[ IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily thaf 1 have read and examined fhis applicafion and kno�r the sama fo be true and <br /> correct All provisions ollaws and ordinmices goremmg fhis fype ot worl<<vill be completed <br /> I whether specifieAherein or noL The granfing of a permd does nof resume to give aufhonty to <br /> violafe er cancel fhe�rovisions of any otl+e�sfate or locnl law reguPting consfrucfion or fhe <br /> perfomiance of construction. That 1 am authonzed by the o�tner o/this property fo perfomi!he <br /> �vork lor which application is ciade and 1 compty wifh fhe Stste Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� � � (�L/ ' ��r �.UD� <br /> 7 � � ��_ <br /> %�jnali�i e oate <br /> / , <br /> Ed�o� -ac-� <br />