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( <br /> ELECTRICAL PERMlT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES q _,y-�r <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C �� pq �/OQ <br /> 425-257-8810 - FAX 425-257-8857—wvwv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED F�20M 8 AM TO 4 PM <br /> !�v 9 ��r� -� � <br /> PROJECT ADDRESS <br /> C�Lf--�c�%? 7C' �= v _ .i�� � �' c <br /> OWner Mail Address Ciry State/Zip Phone <br /> Tenant Mail Address Ciry State/Zip Phona <br /> .'Liq,�L-/$✓�c t� <br /> �C..- r � � s-c--c-rz.c��`Sldo .�£- ��- �zs'f4a U..:R �If�7� �/75 21/clSSl/ <br /> Eleclrical Conitaclor Mall Address City Slale2ip Phone <br /> � -J l'I C`'.� 'c�+�� �9�r� <br /> Sfate L(cense Number Conlract Price of Work <br /> /� �� :�c . —��..a� <br /> Proposed Use of Building Contact Person (Plan Roview) <br /> Description of Work lo Bo Dono: n w i�F- 1-� c �' C' �1 i'f-�- F'-<f'c�YLlcljt <br /> Sr1�•� �J.� l�S �hOL�t" �CY�f� Y%.-J'L,C ��L Y -- <br />� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TlaX CODE IS 3105 <br /> 1 hereby certily thaf I havo reod and examined this applicatien snd know the same to be We and <br /> correcL All provislons o(laws and orr/inances goveming fhis t}�pe of n�ork will be completed <br /> whether specified herein or noL The granling ol a pemut does not presume fo givo aufhonty to <br /> violale or cancel fho provisions o/any other stafe orlecal law renuiafmg consWcfion orfhe <br /> performance o/cons(rucfion. Thaf I am authciized 6y the owner"of Ihis properly fo perlomi the <br /> �vork!or which application is made and 1 compty with fho Sfate Conlractors Law 18.27 RCW and <br /> 296200 WAC <br /> �� !� � <br /> �---. � /-��/i � <br /> Sig alure D6le <br /> Flloq- raq <br />