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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERE7T RERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />._� jr'l ����j� <br />PROJECT ADDR[SS <br />/-1 (`S C <br />Owner <br />` , ij �u, 1-� <br />Tenan! <br />APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM <br />"''i�'I f�rf <br />Mail Address <br />Mail Address <br />j� �c-��c: /l <br />City <br />C�ry <br />L�J/� l �� Zu � <br />StatelZip <br />Slate/Zip <br />9�s-7; �=7;, <br />Phone <br />Phone <br />�. i <br />/�l'cri�7=('l� lr';�ru�'�r�!d�ic ��Cr;h/lSF3 /�'lvl<rll"%o lvi� Ik�'7� �/�t��i�-7(.� <br />Eleclrical Conirector Mail �ddress City State/Zip Phone <br />n��� ��- i r-�� l� i,-�. 'r- <br />State License Number <br />e` >�//� f,�'r� <br />CoMract Price of Work <br />� �� � � � � I 6.. ��•,R/�� � <br />;<<a�,')O�il _ <br />Proposed Use oF Building Conlacl Ferson (Plan Review) <br />Description of Work to Be Done�. ��. -�: .4� /,-t [� C: � G�.'...i /)/- /� ( i �; Ij L; ili � <br />_ l f,�C.,t'�tC:l� <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 />I hemby certdy fhat I have iead and eaammed fhis applicafion and knc�v fhe same lo b� •� and � I�\ 2' I�.'� <br />correcf All piovisions ol laws and o�dinances 9overnmg Ihis type o/ work will 6e compi:_ J � V � <br />whefher spee�lied harein or nof The granfing o/ a pmmd does not presume fo yive aulhonly fo <br />violate or cancel Ihe provisions ol any ofber sfafe or local law ieyulaling conshuction or Ihe <br />peAonnance oI consfruclion Thaf I am authonzed by the owner ol tlris property to peAorrn the <br />worA lor �rhich applrcafion is made and I compty wdh (he Sfafe Confractors Law 18 27 RCW and <br />296. 200 WAC. <br />. : L � - , �^. �, <br />/� - , � r � <br />-TSi3n Wre Date <br />