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�LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, [VERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � " /I "D 7 <br /> '�o` �✓ %�� la r'G l-' <br /> PROJECT ADDRESS <br /> ,lu � �� i1c_Kc. �,�,�i✓ �f;mr as� 9�. sy- <br /> Owner � Mail Address Cily Slate2ip Phone <br /> So-� yr� <br /> Tenant Mail AdCress City SlatelZip Phone <br /> � �— �� �UC� rzs.�sz y�36 <br /> l?2F1N ; ?c: �_�E- �'� Ic. !"-O . /�r;x L• U6�2t_'�' WP, r/�('�lj /' <br /> EleClrical Conlraclo� Mail Address Ci�p S�a�e/Zip Phone <br /> 62r����lE / �LS�3 C c-� <br /> Stalo License Number Contract Price o(Work <br /> S �- P <br /> Proposed Use of Duilding Contact Person (Plan Rew^w) <br /> Description of Work lo�e Done: /)7 (,� �'r_ /i� E 'i f�r:' ��?i� r- F 6� {�F l''D��'.ll _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, fv1C OR AC CABLE. <br />� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have read and exarnined fhis applicafion and know the same(o be 6ue and <br /> correct All provisions ol laws and orAinances govemmg this type ol�t�ork will 6e completed <br /> whether spec�fied herein or noL The gran(ing of a pernuf does nof �resume fo give aufhority fo <br /> violafe or cancel the provisions o(any ofher stafe orloca/law regulating consfruchon orthe <br /> pe�fomiance oI construcfion. That I am authorized by Ihe oirner o/fhis property to pedonn(he <br /> �vork lor which apolicafion is made and l comply�rith fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signalure Uate <br /> rc�� G�}-ll&j <br />