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r � <br /> , <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98301 � _�,Z_p 8 <br /> 425-257-8810 - FAX 425-257-8857-www.eveiettwa.org <br /> �o �pf p"77 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��2u iitu=�t� A d c (�vr-i^.oT r�y�N�+ru � s� <br /> PROJECT ADDRESS <br /> Owner Mail Address City State2ip Phone <br /> 4Z� <br /> te�P�.-iT 1+`(Drnu�\i,s �3aL l�w, R P�b CV�u�r w'�' 4F:�o1 �s�l - 5`�14 <br /> Tenanl M11ai1 Address Ciry SlateRip Phone <br /> Zi3 <br /> /}{� �Ctit1���7�' .`�[K��c..c`3 //Y�ly ti- iPt�K/'�a..v�r t�os" P,�i71t1-L k'?' �/OLr�� 3i�7�-IlfrJ� <br /> Eleclficai Contraclof Mail Adtlress Cily State2ip Phone <br /> ��7�5c�i.i-(17,ZJS �'�t.C�.�:� <br /> State Li��ense Number Cantrect Price of Work <br /> 1?t`�� 7�k Z�3-'3 ��'lllr�l <br /> Proposed Use of Building Contad Person (Plan Review) <br /> DescnptionofWorkloBeDone: _. ���fly'�'v�- ���S7.vh 5c�.iRrTy =y�S721K Ctn.�'�� /�"�"'_�' <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y thaf 1 have read and examined fhis applicafion and kno�v}he same fo be frue and <br /> correcf. All pmvisions o(lax•s and ortfinancos goveming fhis typo of work will be completed '����f7�� <br /> v�hofher specilred herein on�oL The 9ranting o(a permd does not presume to give authorrty to <br /> violafe or cancel lho provisiuns o/any ofher sfate or local law regu/ating construction or fhe <br /> peAormanco o/construchon. Thaf I am authonzed bylhe ownero/this property to�dorm fhe <br /> wo�k(or which application is made and I comply with(he State Confracfors Law iflJ RCW and <br /> 296.200 WAC. <br /> �� hc� �(-/? -C�� <br /> S�gna�e Date <br />