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i ! <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 -DEBIT 6 CREDIT CARDS ARE NOT ACCEPTE� <br /> (�ZO PI�Crtuc�- P�tTH <br /> PROJECT ADDRESS <br /> �LE� ' <br /> tivtieerr t-tousiti�G flumoeir�� 154� EvEeErT wk 982ob (yzS) 3v3 �i il <br /> � state2�` Fnone <br /> Owne� tilail Address City P <br /> Psu`�EE : <br /> �i P�tu�i�JE K�NEv (4zs1t59- 23to1_ <br /> Tenant Mail Addrass City State2lp Phone <br /> BDY'ki� Fl.F_CiRICIr.IG �'U &�X IOR3 I.AkESTFVEt.IS,�uA� 95258 �4Zs) ,�'9�-8`11�5 <br /> Eleclrical Conlractor Mait Address Ciry StatefZip Phone <br /> � /fJ�`" � <br /> �/(J <br /> t3t�rH �59�13C�T' — <br /> State License Number Contracl Pdce of Work <br /> SFR <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Description of Work to Be Done: ��i.AJvE IC��a� "iuBE WiR ttJG g� �FT � ��E� <br /> CN-/��.1 C-�E <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. rJ"j <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that I have read and examined t/tis applicafi�n and know the same to be hue and <br /> correct. ail provisions o/laws and ordinances goveming this type o/work will be completed <br /> whefher specified herein or not. The granting o/a permd does nof presume fo give aufhority to <br /> violate or cancel the Provisions ol any ofher state or local law regulating construction or the <br /> peAormance ot construction. That 1 am authorized by fhe owner of fhis property fo perform the <br /> work for which application is made and I comply wifh the State Contractors Law 18.27 RCW and <br /> 296.200 WAQ ' ' <br /> �-� , 7—/��O s� � ��J7 — �� <br /> ,;. ''� <br /> C � .;- � �� ` <br /> �--SignaNre, Dale <br /> �,� <br />