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i <br /> , <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 PRE ACCEPTED FROM 8 AM TO 4 PM �j_��J_O'7 <br /> ,.� _ i . . , C �7d'i-oi y <br /> �;' `� �Wl� ��vi� <br /> PROJECT ADDRESS <br /> c�Kfl�� /S�ZG h'Yivw `�T . /�i�C. �R�t-r � `�ss0 �Z �t�5 - 3}- <br /> Owner�{��� Atail Address ,$v ilZ= ZI (� City SlatelZip PhonaZ <br /> �� <br /> Tenanl � M1tail Address Ciry SI�le2ip Phone <br /> ��p ��-E_'S�IL 3zA'z �e��Sr ce� t�'1"�'1�- u��'�- �Ze3Y 4?�-��i �- <br /> EleClrir,al Conlfaclor M1fail Address City Slate2ip Phone(� ) <br /> �z� ��t� ��1 l�' �� 33c�o = <br /> Slate License Number Conlracl Price o(Work <br /> CD�oN�liUt �J�'�S si+flvtic ��:L-�� <br /> Proposed Usr.o(E3uilding Conlacl Person (Plan Review� <br /> Descriplion of Work l0 6e Done: �3—�L���'�-- l.�-����P �'�L Q <br /> �i u� �` i�-��r.���� <br /> ( � � <br /> NOTE: WIRING IN NON-DWELLING° IS ;2E�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CACiLE. <br /> 1 <br /> . • <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hcreby certily Ihaf I have iead and exantined this�pplicalion and kno�v the sanie ro be true an�' <br /> correcL Aq provisions o/la�vs and ordinances goveming(hic type o/u�o�k«�ill be completed <br /> whether speafied herein or noL The�ranting o/a pemuf does not presonte to gi��e aufhonfy fo <br /> violate or cancel the I��ovisions ol�ny ofher state or loc�l lan-regulafin�construction or the <br /> perfonnance o/constniction. That 1 am authonzed by the ou-ner ollhis property fo perform the <br /> �verk(or�vhich appli�arion is made and 1 compl}��vifh Ihe Stafe Confractors Law 18.27 RCIM1�and <br /> 2gg.200 WAC. <br /> � � <br /> � :_ - � `l'�I,��- � � �� _ pi <br /> � ,7nat r Uate <br /> v ;�� <br />