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,� <br /> ELEC�'RICAL PERMIT APPLICATIOIV <br /> CITY OF �VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-88F7—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � � l <br /> ��c'� '-� G` Uc'/�r��/�G�� �Q��.�iC/.�l�i9yt_Z <br /> PROJECTADDRESS <br /> .�f�C%C��C�'Sf�U/lJ��'1/Jii�J a�US/// ILJE/✓ ST, ��i �(.�' ,y0^����iJ�y�Lc� -/7'i7 �yy-,�a-o;�o <br /> Owner MailAddress City SlalelZip Phone <br /> � <br /> i�r'S'f /S4 ti /�/0-�_Yc �r,�c�c��/1'�, <d l T�i�� 1 ur�r�f�9,Pc,3J'' <br /> Tenant Mail Address Ciry Slate/Zip Phone <br /> ��u��P�i ��C7(lC ����O /��'r'/����/�r'-P%,Y'Ctl�((<�Y �/1f'l�PY� GJ� /' �r�0 �i�S��/0�-(�J��� <br /> Electn IContractor MailAtldress Ciry State2ip Phone <br /> Vfk.L�c`F�/�//N-i 'P �'SUU. UC� <br /> State License Number Contracl Price of Work <br /> �jr'fu;� , �c7�t' ,���icL) l�%l�L���/�wl,�r,� <br /> � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> j �7/ , <br /> Description of Work to Be Done: J�����%�o� .�t'4i /�.lP /7�t"i:/�� .5.i���'/J'7 ii7 �i�r %X,�'f' /i�+V <br /> � , <br /> ��a�� �x� a ��u�, fa�- ,�e��f%� a�1v :r �i�r/5��,�,t'/�- �1��. <br /> , <br /> %:/fC� ii7c�i:c� f �'[�.�� �i) �Ui77/yl(�iA«c 1cr�^� <br /> � <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 cetlify fhat/have read and examined fhis applicalion and know fhe same to be true and <br /> correcl. All provisions o(laws and ordinances goveming fh�s type o(work will he completed <br /> whefher speci(ed herein or noL The grantin9 oI a permd does not presume to givo authority fo <br /> violate or cancel fhe provisions oI any olher stale or local la�v regulating consWcfion or fhe <br /> pedormance o(construchon. That I am authorized by fhe o�vnero/this property fo pedomi the <br /> work/or which application is made and I comply with fhe Slate Confrac(ors Laiv 18.27 RCW and <br /> 296.200 WAC. <br /> �� //�:' ��.f�2r _��Y,�'S� <br /> � �ign�, � Date <br /> �d � ) _ ..- �� / <br />