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ELECTRICAL PERMIT APPLICATlr,o��� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-wvwv.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& GREDIT CARDS ARE NOT ACCEPTED <br /> ���� �U �-t �/g-2�0 �¢.eJ L <br /> PROJECT ADDRESS <br /> �Z� <br /> ,�l/'/ T �'% °�3� �U �-C lYr2d7 /-K.� e�,f/�-D�C.E�� �Z.ti✓ -�/..� �Oo Z <br /> Owner � Mail Address City State/Zip Phone <br /> T6nant Mail Address City Slate/Zip Phone <br /> 9-s3/ 3/S�'/Ic.� S� <br /> -r�/�/�- �o,uf` C1�' �4�i LL c , luJ��YL�'l� �_�����ri� '{z�33?-3oa� <br /> � <br /> ElectriCal Coniractor Mail Address Ciry Slatc/Zip Phcne <br /> / <br /> f_,�1��� 96 2 � � � oo�= <br /> S ate License Number Contrac Price of Work <br /> ��_ ���'cJnJ L. %C��C-�/� <br /> Proposed Use nf Building Contact Person (Plan P.eview) <br /> 2dG �99P -6LZco <br /> Descriplion of Work to Be Done: a�p /� Vr� 1'�-c/�� ��%A^�u--�2- <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 /> 1 here6y certify that I have read and examined fhis application and know the�ame to be true and <br /> correct All provisions o(laws and ordinances governmg this type o/work H•i116e comp/eted <br /> whether speci6ed herein or noL The granting of a perm�t does not presume to give authenty to <br /> violale or cancel the provisions o(any other state or local law regu/ating construction or the <br /> performance ol construchon. That I am authonzed by the owner of this property to peAorm,the <br /> work/or which application is made and 1 comply with fhe Stafe Contractors Law 18.27 RCW and <br /> 296.700 WAC. <br /> i <br /> /j/ "�-- ��-` �—'2 Z-�j � <br /> Signature Date <br /> E ayo7-�o`f <br />