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( <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 9_��� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.evereitwa.org C/00%��3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�-.i`�: C7L����I�il. �v_\'j�i �\�i�f=� �[���t`� j <br />PROJECT ADDRESS <br />,,�{� 1 f�r <br />�._�� 5��� ��1��) -. A.�� V-� I�vj'.� <br />Owner Mail Address City State/Zip Phono <br />Tenant <br />t�:'"t-�-'�1C4: r_1L�_71 icr�l <br />Electrical Conlractor <br />�1 �1=�� � ��''� 1���� <br />Slato License Number <br />Proposed Use of Duilding <br />h ail Addross <br />City <br />State/Zip <br />Phona <br />;,�,������.�, �_u__ t�fz� ���u°��=::��"�J .�_#�1�� I,�lu,«'t�,c_ ��?<1���1 <br />A4ail �ddress <br />Cily Slale/Zip Phone <br />-1 '1 r� <br />.l,l / '.�iL%1%I j�l <br />�11-G�� _ <br />Conlracl Price oi Work <br />, � '���-�' <br />��`'` �TC�%.:�! � t, I �-C� i J� <br />Contact P�rson (Plan Reviow) <br />. �. _ .�,,, / <br />Doscnplion o( Work to 6o Dono: ��� �'�F�I�1�. ��V i C�-' —iC7 J[�' / j.��'�� <br />NOT[: 1NIRING IN NO(J-DW ELLINGS IS REQUIRED TO <br />BE IN RACEWAI'S, MC OR AC CABLE. <br />CITY 0� EVERETT LOCAL SALES TAX CODE IS :� 105 <br />I he�eby certily fhal l have read mid examineAfhis applicafion end knoiv the <br />cerrect. All provisions ollaws and erdinances �oveir�mg this type ol work w <br />�vhetherspecifieAHerein ornof. The c�ranling o/a perrnd does nof presume <br />violafe or cancel lhe n�ovisions oI an}� olher state orlocal �aw regulating con <br />pe�fonnance ol cons�rur,�ion. That 1 am authoiized b}� the oa•ner oI th�s prop <br />waklor nhich applicafion is rnade and 1 compl}� �+ith the State Contractors ! <br />29G.200 l4�AC. � ' <br />_ _ , , , � , =;,=� <br />e fo be truo and <br />cornpleted <br />✓o authonty to <br />fion orthe <br />o pedonn the <br />8.27 RCW and <br />FEE <br />� -> <br />lC�, � - �5 <br />