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( � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � —�� �lZ <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org ����_�`2i <br /> APPLICATIO�VS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> fi� 7 L�.�/� �� <br /> PROJECT ADDRESS <br /> 11'L �H r�� ,e'i-�� s4,�� <br /> Owner Mail Addross City State/Zlp Phone <br /> Tenant Mail Address City Stale2ip Phou�; <br /> ��� L�CG�i^ ��� �J 5� s� l!/K..u�— ��' !.�/B� J.��.��� <br /> Plecfrical Contractor Mail Address City StaleRtp Phone <br /> �/�Sd � ;!F �`' 0.2L L3 Z /tSv� <br /> State Lfcense Number Conlract Price of Work <br /> /1 <- � ./- <br /> /l K�i w�v� <br /> 'Proposed Use of Building Contact Person (Pian Review) <br /> Descriplion of Work to Be Done: G ��.,�n. - /� � � ���- w'"'�- �'C� ���" <br /> i��p <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 /> � ) Z��-�' o�- <br /> I hereby certify that 1 have read and examined this application and know the same to be true and <br /> correct. All provlslons of laws and ordinances goveming fh(s type of work wi116e completed <br /> whether specified herein or noL The granting o(a permit does not presume to grve authonty to <br /> violafe or cancel the rovisions of any other state or local law regulating construction or the <br /> perfomiance of cons�ruction. That 1 am authorized by the�wner o/this property to perfortn the <br /> —work-for-which�epplicetiondsmsde and-Fcompfywifh�lhe-StafeGontractorsLaw-18r2FRGW-end- <br /> ^ 296.200 WAC. <br /> �� 1 � // L� / <br /> 1��0� Y�/r.G� ( '�C�1�r«_ <br /> Signalure Dale . <br />