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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 7`-�y `�� <br /> 425-257-8810 - FAX 425-257-8857 -www.everethva.org [ 1/D 7�06,3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2o1S v�ow�\coc (�,v(_ �,, �.�� ETT , ��. i ' <br /> PROJECT ADDRESS <br /> � � �Z �.� .�C I Z ��.C ��t c P t'.JF � �.'� ,� r � T .�, .�— <br /> Owner Mail Address City Slate2ip Phone <br /> Tenanl h1ail Address Cily State2ip (��4�_ Phone <br /> •!('3G (p0�'-� S'f J�E' <br /> ''�*-�L �Fr ��Ec'tn� c ��t� c��cFS v.,� µ. ,��F,,. �ic t �.�w n� ���v <br /> ElectriCal Contractor A1ail Address Cdy State/Zip Phor�e <br /> '��l��EsgaokG ��5� 735�`-// `�.� S .�vz� . <br /> Slate License Number Contract Price o(Work <br /> i3,c ,a `�:�t-� , tI 2 J � r I"i b aiI I <br /> Proposed Use of Duilding Conlad Person (Plan Review) <br /> Description of Work to Be Done: �t�L� +� � vJ�ti-�t`'( 1 ��l. E �( l� �)1�(-�'R ��� \2 C- �i. �k C t' <br /> iC l�� tkT��t , � �•.,��,� f-C 6 �! C , � �',i�,C�(� �� n ( . ,• ��� ' � �CU <br /> � � <br /> L [�C C , \�_ '�..Ct)��.1 " �i+. � C' � '�1 C . \t ` S�i t-t C �-. • . • � . . . <br /> ll. <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FE[ <br /> BE IN RACEWAYS, MC OR AC CARLE. <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br /> 1 hereby cmtily(hat I have read and examined Ihis applica(ion and kno�v the same to be truo and <br /> correcL All provisions o/la�vs and ordinances goveming fh�s type of�vork ivill be co�riplefed <br /> whefher specifieAherein or noL Tbe granling o(a permd does nof �resume to give au(honfy fo <br /> violate or cancel fhe P�ovisions olany ofher sfate or locallaw regulafing consl�ucfron or fhe <br /> perfomiance o/consfrucfion. Thflt I am autho�ized by fhe owner o/fhis prepen;(o oerlorm the <br /> work lor which applicafiai is rnade and!comply�vifh fhe State Confractors Law f?27 RCW and � <br /> zss oo•w�ac. <br /> , I' O�— Q� <br /> . 7i�y/` r <br /> ignature Date <br /> L� <br />