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. <br /> � - - <br /> � ELECTRICAL PERM;T APPLiCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org ED �2 ` �3� <br /> APPLICATIONS ARE ACCEPTED �P.OM 8 AM TO 4 PM °� —`� S'�� <br /> � � , <br /> �� / <br /> � � ��� D �� .E�A.t �C� �U " < ,' � �i� <br /> PROJECT ADDRESS �C� - ��J ,����� <br /> yj i� � I <br /> �� 1 ��i ��' a,,.�1�c�r�GlcvA.i /�//'/lh��(. �.�iJ�o�-<��s' <br /> Owner Mail Address Ci1y Slate2ip Phone <br /> Tenant Mail Address City StatelZip / q�/ Phor}e <br /> i �T�9'/?.�• I/ C•(� <br /> � � % J <br /> ��7 `J Si�Nr. . �j , �t l,G /'��t"� �vl�`����E �1 �,��.��,�;�� 1c�,4 i'j.S"�'�G. I <br /> Elecirual Conlractor Mail Address Ciry State2ip Phone <br /> � � _l �' G <br /> 1���� l�! �l/_ % /C� � r) C,- --� � �7�� <br /> Slate License Number CoNracl Price o(Work j , <br /> � , �, ] � ) •/ <br /> lr'� �/��,� .��� �/iI L ��C... r �(�� �Jl�/.'%c� /�/U�/.✓iJ!•" <br /> Proposed Use o(Building Contact Person (Plan�2evie�v) � <br /> / � �/ i - / >C� � <br /> Description uf�Vork to Be Done: G� .1//( < <'�'c` ;.� � <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 certily fhaf I have�ead and examined this application and k�io�v the same to be true ann <br /> conecL All provisons o(lan�s and ordinances gaverning flus lype o/�vnrk n�dl be compleled <br /> whe(her spea(icd herein or noL The granting o/a pennrt does not piesume to give aufhaity to <br /> violafe or cance!the provisions ol any other sfate or local law rngu/ating construcfion or fhe <br /> perlormance o/consfn�ction. Thal l am aidhonzed by Ihe owner o/Ihis propert}�fo perfomi fhe <br /> work!or n�hich application is made and 1 compty�vifh fhe Sfafe Conlractors Law 18.27 RCW and <br /> 29ti.200 WAC.. / <br /> ; <br /> L. � <br /> �'� ��' � f� /�' /li `�)�� -� �✓Jl� -D ,� <br /> Si nature Date <br /> � ����- 1�� <br /> �3 <br />