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,ii � �� 21U� <br /> ELECTRICAL PERM�T APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � ` � ✓_;,5 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> �!{��=`uert7!` .M4.// LJ�•.�j Euerell' L✓A `�SZo� <br /> PROJECTADDRESS � <br /> �GeG �iAe�//� 1910) N. 7�1L. .d�[. T�+eCniX /Qz �fOZ] �6:3�f97-7J69 <br /> OWnef - MailAddress City Stale(Zip Phone <br /> P�f�A� ��z��r <br /> Tenant MailAddress City Slate'Zip Phone <br /> `Gaat'p� ,.rr ISl� �6�/c f�.m/�. O�K /1..0 Fde., Qr�. .,�e H,� ss1�'h' sst-z�v- 7� <br /> Electncal Contractof Mail Address City State2ip Phone <br /> ELD66A LNEG�SSo3S35s E�P: 7,Zs/oS )2 zsv. ov <br /> State License Number Contract Price of Work <br /> PL�1'� nGrL AnelrL� F�+�SKi <br /> Proposed Use oF Building Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: ynS�/'ai/a7io� �<- ��%��'�t� M�"'��r�^y fy��"� <br /> NOTE: WIRING IN NON-DWELLINGS IS RECl�IRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LGCAL SALES TAX COD[IS 3105 <br /> 1 hereby certi(y that 1 have read and examined this application and know fhe same to be frue and <br /> wirecf. All provisions o/laws and ordinances goveming this type of work willbe completed <br /> whether specified herein ornot The granting o/a permrt does not resumo to give authonty to <br /> violate orr,ancel the provisions of any other slate or local la�v reguPatinq construclion oi the <br /> pedormance of wnsWction. 7hat 1 am authonzed by tho owner of this property io pedomi the � <br /> work fo�wh�ch application is made and I comp/y wi(h the Stafe Confraclors Law 1827 RCW and <br /> 296200 WAC. <br /> ;�� .��.f/oS <br /> Signat r Cate / � <br /> �` "r_>�� � � ( <br /> � <br />