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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 /> ,�:� s,� 9 o��K� s ��J� � <br /> PROJECT ADDRESS <br /> �� �Ti � 11�6.�,7 � u.i'/ 7 (j .PfL�nl<✓c'LU /PYL� �✓ ScS»7� E �16/�'S <br /> "'i c C'FC'�/i' <br /> Owne� Mail Address City State/Zip Phone <br /> ��E GC C7 A �il?iE.t — ���/�pr' /�OL+/L y.?-S - �'y� ..� � =� � � <br /> Tenant M1fail Address Ciry State2ip Phone <br /> B� c�E ,c'i.���ni ErEc �cb� v Bz .9v£ Cr/��s; f'e/rc�1 ��2%�� <br /> Eleclrical Contraclor Atail Address Ciry State/2ip Phone <br /> yzr-- »>.,��E <br /> �� cl E. �' E.T j (�, � G' �l /`� li��U <br /> State Licanse Number Contract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description a(Work lo Be Done: .�����';"�I!c� ,'�a'' %-�,;�l- •'',�J<<<� �' 7Y�/� ,s'[ �Y�,r <br /> (!/�G��/�OE �%Z� �GyQ /.�Ni"r .�f.�'<�iL�� i'�� />.�i� y�Uo� <br /> l!i'Gv<'/lo,f C=.C'Cr/.✓.J�NC. l�G'f-' ,007/✓ /J'/{n/�2C_• !i'LD <✓J�7C-iE' ,�''04S <br /> !�'CN D/n,�l <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 he�eby certil}�tliat 1 have read and examined this application and kno�v the same to be Vue and <br /> conecL All prowsions olla�vs and o�dinances governmg fhis type of u•ork u�ill be completed <br /> whether speafied herein or not. The�ranfing oI a pentul does not resume fo give authont��to <br /> violate or cancel lhe provisions o/any ofher state or locallaw reguPting construchon or fhe <br /> pe�formance o(construcGon. Thaf 1 am��uthonzed by fhe owner oI fhis proparly to peAorm the <br /> work lor which applicafion is made and 1 cornply�vifh the Stafe Contractors Law 1827 RCW and <br /> 296.200 WAC. <br /> i /"'� � � - �, <br /> /��//;f, ��/��' /� - � C 7 <br /> Signature—� Date <br /> �U��I -Iy5 <br />