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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C{ ,. a—D S <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org C o go 4 _ o0 5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��'�o E-Ic�i�-H n,,� � vcr.�tt, ��/� ���� I <br /> PROJECT ADDRESS <br /> 8lr �l l�C�) �.LC� -�jlu�� c�i '� /IIIu- S .�P�.��f�� I.J�I ci � �JS .1U6 '�12)'• �l$� <br /> Owndf� A1ail Address City StalelZip Phone <br /> lcr�r�.col�. 2P � �cJc� S�oy �-�f 4 �1v� s. .��HC�, �n- ,`Si�� ao�- �zs -� �- <br /> Tenan� A7ail Address Cily StalelZip Phone <br /> } \ N "`�� �1�_/�[1 C 1111� <br /> Electri I Conlractor � tail Aadress Cily Sta1e/Zip Phone <br /> �] i ���-✓ ci c11' ^ ��� Ct,n f,� o�or- �p 7U00 <br /> State Li ense Number Contract P ce of Work <br /> � ras+�i.k,-�,,•.�— �'l�v. v ��Q Mc� lA-Il�skl-(u1, <br /> Proposed Use of Building Contacl erson Plan Review) � 99-yss�� <br /> a�i�- 1 <br /> Descripiion o(Work to Be Done: �-�r�t � � �C c�`�i C� C)�i- (ef� �t ��� :,J� Y i v�,� �.1. — <br /> �'�� Pmc � �E— Q � /'�f ✓'P��+..t �-'1uc•. G-�r U � 70 �7 '� Z3 <br /> 6' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE ,)j <br /> BE IN RACEWAYS, MC OR AC CABLE. �n`�S <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily Ihal I have read and examined th,is application and know the sarne to be true and <br /> conecl. All provisions ollaws anAordinances�ovcrnmg this IyUe ol work will be complefed <br /> whefher speciGed herein or noL The granling of a pemut does nof resume ro give aufhonty to <br /> violate or cancel fhe Provisions ol any ofher sfate or local la�v reguPating construclion or fhe <br /> peAonnance ol consf�uction. That 1 am authorized by the o�vner o/fhis property to peAomi fhe <br /> work lor which applicalion is made and 1 comp/y wifh Ihe Sfale Confracfors Law 18.27 RCW and <br /> 296200 WAC. <br /> �yr-�• �'��_s� � d/z/QS � �C��-oo� <br /> Si�naturc Uate �/ <br /> f_. <br />