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�v <br /> ELECTRlCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org 9 V � � � �5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l / �� 5 � f"v �i�Gr� ,tTa-C� �✓c�� <br /> PROJECT ADDRESS <br /> ��' ��5� �Vef�C%�" l�`�.. �0��! SG✓. l�i/T�h i� ���.1�c�rf/.F2cLi �!'-t �jZ 60 <br /> Owner Mail Addrrss Cily State/Zip Phone <br /> ��4-� h f�+�, �.,�1 ��y e.�U( <br /> Tenant Mail Address City State2ip Phone <br /> ��3Ct�c, C�,�,mnu�K'�;��� �S+�,t��� .I.vC ��� y N.oJ � �! � P�i 5��r����aL 6�c� `j8/�7 <br /> EleclriCal ContfaCtof Mail Add ess City State/Zip Phone � <br /> � �o6� T�d 89Sk' ' <br /> I /�c�f rooc ,� c._ 5� �0, �� <br /> State License Num:,er C rlracl Price of Wolk <br /> � �, <br /> Ce.:u.z�ti f�� L l�ti,�� SPr«�� <br /> «:� b <br /> Proposed Use of Building Contacl Person (Plan R�view) <br /> Descripliun of Work lo Be Done: G.-U� \l����rj`j e �(/Tl S I-c� .— V C lCt <<�� �<J � <br /> rf <br /> NOTE: WIRING IN NOIJ-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. --�_� <br /> � � <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i 1 hereby certily fhat 1 have rcad and examined fhis applicatipn and kno�v Ihe sanie to be frue 2nd <br /> cerrecL All provisions ollaws and ordinances govemmg tfus type o(�vork u�ill Ge completed <br /> �.;f�ether specilied herein or noL The granfing o/a perrnit does not resunte ro g,ve aufhonfy to <br /> � i iulate or cancel the provisior.s olany other stafe orlocal law reguPting construcfion or the <br /> nerlermance o/construclion. That 1 am aufho�ized by tlie owner uf Ihrs property fo perlorm the <br /> � II '��,vrk Ior which applicafion is made and I comply with fhe Sfate Contractors Law 18.27 RCW and <br /> �96.200 WAC. <br /> ��� 7�' •. <br /> i Signat e Dale <br /> � <br /> v f� � / �f <br />