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I <br /> 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 <br /> �_ '� D � ��til llti�.F��C'., ��U-� . <br /> PROJECT ADDRESS z a�`��S <br /> 1 -7�dj>D <br /> -J������-1 �� I �:v�v��1�- 2 l � f - /u w�roe A�c L<-�nF_h� � uJ¢ <br /> Owner Mail Address Cily Slate/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> RI�,A r- ��-�;tZ�� ''�-bbS �o� ��. ;;� . ��-,otib��51-�. ��, ��"Z�io- <br /> EleClrica�Conlraclor Mail Address � C Y Slate2ip Phone <br /> AI�A L-��G��SlUP : � ��-o� 771 � �_ <br /> State License Number Conlracl Price of Work <br /> `�....,4-_ �.,.�.��� <br /> Proposed Use of Building Conlact Person (Pl�n Review) <br /> Description of Work tu �e Done: <br /> �?�D �tu^(� (�i�,�L.o«� ��ar�. �c� L�.cuc,� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I� <br /> I hereby certdy that I have read and examined Ihis applicafion and kno�v the same(o be frue and <br /> conecl. All provisions of laws and ordinances govemmg fhis fype ol work u�ill be coniplefed <br /> whether spec�6ed herein cr noL The granfing o/a pernut does nof presume to give authonty to <br /> violate or c ncel the provisions o/any ofher state r focal law regulafing consln�cfion or the <br /> performan e o/construc6on. That 1 am a orize by Ihe owner ol Ihis properiy fo perform the <br /> work(or wl ich application is ma eand comply� dh the Stafe Confracfurs Law 18 27 RCW and <br /> 296 AC. `. _ <br /> � i--� ` _ __ �l ( s �Zi�. <br /> Sig aWre Uate <br /> � d U��T''�� � <br />