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ELECTRICAL PERMIT APPLICAI'ION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C� ,_J S _b <br /> � E ve+�e-N- 1'��1\ 1,���0.��_ <br /> PROJECT ADDRESS <br /> �,C.k, l,l�,il�o vi�5 <br /> ���eC��-�)-4- �1;�`�1�I-la$5�1 <br /> Owner Mail Address City Stale/Zip Phone <br /> �t a Mc.1k X �k ICR� r-,�� �.���� ����►� ��� ����� wb �x2o� z�� ��z ���� <br /> Tenant MailAddress City StatelZip Phone <br /> :jida lu3�c� <br /> F��,rv� ��ls�tv�c ,l,�C � Pt� �r�2iJ7 ��nG���,�,� ��A �`��3�� 'a�`� <br /> EleClriCal ContraCtor Mail Atldress Ci�y( SlatelZip °hone <br /> �s�,�e�, ���l,l �� �lo� `�' <br /> Slate License Number Contract Price of Work <br /> (� �r�e <br /> �� � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work ta Be Done: � � V�,1_ � I`�`'V C�S�CQ- \�i 1�/\�� ���� (11�Q �'/l'LG:h�'SUCI�' , <br /> o�` O ` <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ���,Lv <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r� f� <br /> I� 1 hereby certiry fhat 1 have read end examined this application and kno�v the same fo be Irue and �D�v�� v 1 (� <br /> conecL All provisions o/laws and ordinances govemmg fhis type ol work will be completod <br /> �rhelher specilied herein o�noL The granting ol a permit does not resume to give authonty to <br /> violate orcancel fhe provisions olany otherstale orlocallaw reguPfing consfruc6on orthe <br /> perlormanco o(construc6on. Thal I am authorized by fhe owner o/fhis propedy fo peAorm the <br /> work Ior which application is mede and 1 compty with the Sfafe Contracfors Law 18.27 RCW and <br /> 296200 WAC. <br /> � 'n�, � 1'l�^GI/�,1�____ , / -1 J v� <br /> Signaiure Date <br /> �t c�US ��� $. <br />