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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STHEET, EVERETT, WA 98201 <br /> 425-257-881Q - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �z' ' �7 —07 <br /> G o'7Jz -08�3 <br /> i 3z�-i �'�!���� �v�= <br /> PROJECT ADDRESS <br /> � z�� - 35 <br /> �,�F ���'2fI�S i57�0 /n�}w5-r S�reZld MiUrcc-�� u)?- rS DIZ � zYt:: <br /> Otvner P.1ail Address City StatelZip Phone <br /> Tenant Mail Adaress Ciry State2ip Phone <br /> n ;�s- 3s� - <br /> I'� � t=r(�{�.L� z�,,�(/`�' Sr 5� �=n.r�fT' i�1�- uf+'ZGS' G �(O <br /> Electrical Cuniractor Mail Address City State/l.ip Phone <br /> 7, �=� �� �i'� i �P � 3�� V <br /> Slate License Number Contract Price o(Work <br /> �'�;.?��t.fv\ <br /> ('Oi�DOP,q �1�;���.'l S SFhM1��.� �Fazr,vr.,.�L-cwuer J <br /> Proposed Use of�suilding Contact Person (Plan Review) <br /> Description of Work lo !�e Lone ��i'��` (' (� 1�D.a�2�.N Ll�.ft '7' ��� v�-T � !�. �= <br /> c ti /�)F�ic.J <2 ���ri'�:CCi ax � <br /> i� -Ic' -r ���, <br /> NOTE: WIRING IN NON-UWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceAil}�thaf 1 have iead and examined this applicafion and kno�v the same(o be true and <br /> correct. All prnwsions ol laws and ordinances govemmg this f}�pe o/�vork u�ill be cornpleted <br /> whelher specdicd hmcin er not Thc granfing o/n pernut does nof presumc ro giee aufhonty fo <br /> violafe or cance/the pro��isions oI any other state ar local/a�v�egu/ating construction or the <br /> peifonnance of consfruction. That 1 am aufhorized by the owner o/tbis pioperty to perform the �� <br /> �vork lur�vhich application is rnade and 1 comply�vifh the Stafe Contraclors La�v 18.27 RCW and � _ <br /> 29G.200 WAC. � ' J I,-' <br /> j�� �� v-c/ <br /> � <br /> � il,i�� '� � � Z- I�)-0 �- <br /> Slgnature Date <br /> i <br />