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�_ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 17� �-�� ��.� i � �� <br /> PROJECT ADDRESS <br /> �e �e >�" Kc� � 1�11 �lew�%' ,��e%'ei� w i= � ���-�'( <br /> (lwner Mail Address Cily Stale/Zip I/ Phone <br /> 1 T.�S^S!�^ . <br /> �cc�r�����nd Il�ll� /�/i ��l Gt� �� f��/� �i/c�rr�' ��A ��2L�� � Y (,n <br /> Tenant�'/'K Q-n fi�GyL�� Mail Address City Stale/Zip Phone <br /> � � ` . <br /> '� UJ ` ',,' <br /> EleclriC81 Onfractor Mail Address City State2ip Phone <br /> . �J�� �� <br /> State License Num6er Contract Price ot Work <br /> �-l7t! ��� � Sr'<<'�1c��Ytl�kL �-u.t�/�ti�7,aY� �.J.� j�r�ll1 r�Y—.��`�j '� � 6 <br /> Proposed Use of Buiiding - Conlact Person (Plan Reviow) <br /> , , <br /> Descriplion of Wark to Be Done: �� Il � � �a .,L � � �1 �"/�S W/5�'U �"j C�-� � J <br /> ? t�xaU�57 F�ti�7 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��G'(J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhal l have read and exami ied this applicafion and knov. the same to be frue and L I P�3 (��� <br /> correcl. All promsions of laws and ordinances goveming this type ol work will bo complefed � �lJ <br /> whelher specified herein or noL The granfing o/a pemiR does nof presume to give aufhonty to <br /> violafe or cancel the provisions of any other stafe or local law regulefing construction or Ihe <br /> perfomiance o/conslrucfion. That 'am aufhonzed by the owner of fhis property to podomi Ihe <br /> �vork lor which applicafion is made and 1 comply�vith t�•�otate Confractors Law 18.27 RC W and <br /> 29G.200 WAC. <br /> `��� 3 � �� <br /> Signature ale <br /> ����,ti�; � F �: w � � � <br />