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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 /> I �{ /� �A-Q� � K <br /> PROJECT ADDRESS <br /> M �Ic� l�w�"��,� � ��s ►'�� �� ��tc�T vA-y'sz.�3 <br /> Ownef Mail Addresr. Cily Slate/Zip Phone <br /> I Tenant Mail Addres�. �/ City Stale2ip �v <br /> 7GI f �V'G/' C�N W�y #� y.�K7 �c�L7/e <br /> , . o � � . ��� �de�e � CJ,� 98zo� 3� <br /> Elec � al Contraclor Mail Address Ciry State2ip Phone <br /> r3 P1 � N�'T 9� zc � US?�v <br /> tale License umber Conlract Price of Work <br /> S � f1 f}(. �fZS�T�f�o �SS� <br /> Proposed Use of B Iding Contact Person (Plan Review) <br /> � Description of Work ro Be Done: � W�� `�� S�`� � � � L14 M-FS N� � � <br /> I �� Vice�t o-w.. � - <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. "� � CD <br /> � � <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> 1 here6y certily thaf 1 have read and examined this application and know fhe same to be true and <br /> � correc(. All provisions ollaws and ordinances governing this lype o/work will be completed �r,'7 _ I ��, <br /> whefher specdied herein or noL The granling ola permd does nol resume to give authonty to � I U C. � J <br /> violafe or cancel fhe provisions oI any ofher stafe or local law reguPting construction or fhe <br /> peAormance o/conslruction. That 1 am aulhorized by Ihe owner ol this property to perJorm tlie <br /> work lor which applicafion is made and 1 comply with fhe Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��� r �� O 2//��Zo/ <br /> Sic�nature Oalo � � <br /> I_ —__ — _ <br />