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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES / <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �D— I g— D(� <br /> 425-257-8810 - FAX 425-257-8857—Krvvw.everettwa.org � 0 6 �� _�a5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,�71�'� M-C��N� J�r ' <br /> PROJECT ADDRESS <br /> �?Uc �fllC/ .y/till'�i;w''/{�S <br /> OWner Mail Address City State/Zip Phone <br /> /!9/�,�� /1�d,(/e� r1J �/2'S-3o�f-'S3/D <br /> Tenant Mail Address Ciry State2ip Phone <br /> �'c��1 �yff�;� 2z/� �v� �s� ���f� �,�1�, 9�f1� y�s',-�dokL� <br /> EleClrical Con�raClor Mail Address City State2ip Phone- <br /> Ly�l K� SyV S�3.3 C� <br /> State icense Number Conlract Price oi Work <br /> ►''J;N�r'k 11"iQ�iLzA hif,�C� <br /> Proposed Use o(Buildinc� Conlact Person (Plan Review) <br /> Description of Work lo Be Done: C�5��"�" ���(7/`�- ��""� J/Ql�/ <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 TAX CODE IS 3105 <br /> 1 hcreby certi(y thaf 1 have read and examined this applicafion and know fhe same fo be true and <br /> con'ect All provisions o/laws and orrlinances govemmg fhis type ol work will be completed E U��p- �z�"7 <br /> �vhether specified herein or noL Tbe granting o/a pamuf does nol presume to give authonty to <br /> violafeorcancqf�provisionsolanyofherstafeorlocallawregulafingconsWctionorthe <br /> perfonnance 1 con tnrcfion. That 1 am aufhonzed 6y the owner o/fhis property to peAorm the <br /> work lor�vh' h appl ntion is rnade and 1 compty with fhe Stafe Contracfors Law 18.27 RC W and <br /> 296.200 W C. <br /> > �d' /� �< <br /> Si a � ate <br />