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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERET"i PERMIT SERVICES <br /> 3200 CEDAR STREEl, EVERETT, WA 98201 y y�I_�Z <br /> 425-257-8810 - FAX 425-257-8857 -www.everetiwa.org <br /> ��zoq-�a�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �a�5 fYl r��ll G�ee.l� P 1� <br /> PROJECT ADDRESS <br /> Owner Mail Address City State2ip Phone <br /> .�TQ l�'loh,�I,�� P ��x I�a5�6 < � �„b,s r�h� � LI��� <br /> Tenant Mail Address Cdy StatelLp Phone <br /> `�-�e�.� Po�,�S s+��,s aoi no,.-ra�� �a N Pa�;�'�` u�A �ko�� a53•q31• �daa <br /> Elecirical Conlractor Mail Address Crty State/Zip Phone <br /> �ATT�Dsqao�c� � �63� <br /> State License Number Contract Price o(Work <br /> (� � �Le i-�e �L _ <br /> Proposed Use oi Building Conlact Person (Plan Review) <br /> Descriplion of Work to Be Done: ���'� �X �S� �� r��e�� � ��`e�U✓\/� <br /> ��� �c�v �p v�n�� �s�"u�l �e r.� �-L�,, �n�/�n�Q �I G,�c,vr c h <br /> li <br /> � �� r � � S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. I g � . S S <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce�tily that I have read and examined this application and know the same fo 6e tn�e and r- � ,� �` r _ �S� <br /> correcf. All provisions o/laws and ortlinances goveming th�s type ol work will6e completed t �t <br /> wlrefher specified hernin or noL Tlic granfing ol a pemvf does not resume fo give aufhonty to <br /> wola(e or cancel Ihe nrovisions ol any othersfate orlocal law reguPting consfn�ction or the <br /> perlonnance ol construction. That I am authonzed,by the owner ol fhis property to peAomi the <br /> �vork lor which applica('on fs rnade and 1 comply wdh the State Contractors Law 18.27 RCW and <br /> 296.2 0 W� <br /> � ��� t� � �� <br /> S gnaWre Date <br />