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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES /0-S-/d <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �L� /O/� -DOZ <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 11.32. rn��1� ��. <br /> PROJECT ADDRESS <br /> � i <br /> i�v` �'AttG,�'{� L.w /!�� �„�tinlP >�� f_vere(� �n1 A . `/�'20� yZs-2S2-�s <br /> Owner " Mail Address City State/Zip Phone <br /> Tenant Mail Address City Stale/Zip Plione <br /> C � <br /> Eleclrical Contraclor A7ail Address Cily Stale2ip Phone <br /> $ /�� G� zsE,'�natec{ <br /> Stale Licenso Number Conlract Price o(Work <br /> —/' ) /"��Lhne_ ' �2 ; �25 ZS Z ��S'' � <br /> 5 � Yl/ I� 'T6t v11 i I �I <br /> Proposed e of Buildinc� Conlacl Person (Plan Review) <br /> Descriplion of Work lo �e Done: � 1 Y�� �'�C� •��[`� ��\r�e �11 � CL.�1 c� G1 c��iJZ, � <br /> (.��,lr;l � t� �►� ? c <br /> 7 <br /> NOTE: WIRING IP! NON•DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriily fhaf 1 have read and examined Ihis applicnfion and know fhe sarne to be frue and <br /> correct. All prov�sions olla�vs and ordinances�ovemmg this type of work will be completed � <br /> whefher specilied herein or noL The c�ranfin�o/a pernuf does not presume to give authonry to 1 <br /> violate or cancel the provisions ol any other sfate or local law re�ulating construcfion or fhe /� �� / <br /> perfommnce o/construction. Thaf 1 am aufhonzed by fhe owner ol fhis property to peAonn the �t/L <br /> �vork lor�vhich application is made and 1 comply�rith the Sfa(e Conhactors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /.-'1 �'171�� <br /> Signature , /� Dale <br /> I . --- - � .._ <br />