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i � rs -ti <br /> ELECTRICAL PERMIT APPLICATIC�N <br /> CITY OF EVERETT PERMIT SERViC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEpTED FROM S AM TO 4 PM <br /> , <br /> II �i��, _`�1_ �— �i!_i1=�T �V/14��—�„���-v �iT_ II_) �' �- L� <br /> PROJECT ADDRESS <br /> ` ` � i Mr_��lyr.�� � 'iC� <br /> / . � <br /> ��,luU�ri 1��`\ � c(';'.\[ 4C�tl���)r. �1'�� �l-aF_•..�. V.�!\ 1�����_ �_ <br /> Ov.ner Mail Address Ciry Stale/Zip Phone <br /> �Ji� i'7 �;" -�'..�;�, �1�'.c '��tC-UFP4:Ti"1L� W�-t �JEf_..�' �,IA �4.c.Ot� F.iI� <br /> r <br /> Tenant MailAddress City State2ip Phcne <br /> ^� . <br /> 1-�P< L' - 1 � l�i ���Y,SL;- �ui'_�,(i�C� �,.l�a 9P,C3"L z't'L1795-C;ill <br /> ElectricalConlractor MailAddress ciry State2ip Pnone <br /> ,i <br /> 1—iP�=-c3 - k �;�.,-, KG� l/' lL'`�Y._UU <br /> State License Num6er Contrect Pnce of Work <br /> -� ��1�,�,_ �,l K��_��. <br /> 1� F-';n>�:; p. — _ - <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> OescriplionofWorktoBeDone: �— ��;i'_ ���;-��.c� T �\_ 4�h �� O-v �`.�_ti <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FE: <br /> BE IN RACEWAYS, MC OR AC CABLE. ��' ,��� �� �/ <br /> ! <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have 'ead and ezamined fhis applicafion and kno�v the same fo be frue and <br /> correct. All provisions o(laws and ordinances goveming this type ol work�vill be corrpleted <br /> whether specified heroin or noL The g2nfing ol a permd does no!piesume fo give authonty to <br /> violate o�cancel the provision;ol any other;tate or locallaw regulafing consWction or the <br /> per/ormance ol consfruc(ion. Thaf 1 am authonzed by fhe owner o/this propeRy fo pedorm the <br /> work for which application is made and I comply wifh the Sfate c:ontrar.tors Law 18.27 RC W and <br /> 296.200 WAC. ,.� <br /> i ' <br /> /� � 9 i.-',/% IJ <br /> '� ' ��. � . '/� ��'. ��// 'G�� � <br /> „ignalure Date <br /> r,��/- c'�� <br />