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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 s�.l� —�p6 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> G--�6v 5'a�6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1905 � I�Ie�J���k Ave �vc�c�++- �,.�n 9�,52�� <br /> PROJECT ADDRESS <br /> Ownef Mail Address City StaleZp Phone <br /> J� L�y�vti < �2ccv/� f '��I.� �(�nn.� v,�ru n- £c/.-i-,n(1 l�• 9koZ� ZnLri�yi�y4 <br /> Tenant Mail Address City Shate2ip Pha�e <br /> 5��� ���;�s,,-, �z�3 i�� r� 5� ��HNI.t/�ld 9��3� y�s3y�-s�9 <br /> Electrical Conlractor Mail Address Ciry State/Zip Phone <br /> _6oZ Lov 13o RobinelqqlJy �l�l�� I, Io� _- <br /> State License Number Contrac�Price of Work <br /> _S�`GVC It 04;�i1 S OH <br /> Proposed Use of Building Contact Person (Pla�Review) <br /> DescriplionofWorktoBeDone: �tia;c1��u� t�1�� Llt � l lH _S�-�ir-lid <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 here6y certily fhat 1 have read and exarnined Ihis applicafion and know the same fo be true end <br /> correcf. All prov�sions o/laws and ordinances govemmg this type of work will be completed <br /> whether specified l�erein or not. The granfing of a permit does not presume to give authority to <br /> violate or cancel the provisions ol any other staie or local law regulafing consfruction or fhe <br /> perfomiance o/conslruction. Thaf 1 am aufhorized by the owner o/this property to peAomi fhe <br /> work lor which application is made and 1 comply with fhe Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /�%r � � "'� <br /> �i! � iG� � S / � � <br /> ignature� Date <br /> �� /�j�/,��o <br /> UN � <br />