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ELECTRICAL PERMIT APPLICATInR� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8810 - FAY425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM11 TO 4 PM i� ��S_ G(�, <br /> [_ V��'�-/— I � <br /> 7([)�� hfl���It�i�./n� ��R <br /> PROJECT ADORESS <br /> L i isNc�' i�s�.s� s3�� A �� sc, C��c�ETr �vA 9�:cs <br /> Owner Mail Atldrass Ciry S�ate2�p Phono <br /> ���,�Gu�.�e_ � �,'T hc�F 3 �/,P zz I ti'c 7ZN.� �1,���, REnn�oNo, lc�q 9 5"n.SZ <br /> � Slatc2i Phone <br /> Tenant Mail Addmsc Qty P <br /> t"xrc��C�c�cr���,/NC �lG�l�� 9/��'��ic� AF'; Tt'o���� l�'A 9�'y���-.�5> '(7�-I��o7 <br /> Electrical Contractof Mail Addross Gity SlatmZip Phcne <br /> �x���c>n�z�r �9,?�0, vo _ <br /> Shate License Number Contract Pnce of Work <br /> /� � <br /> (:Cl � 1ll ���: ��d�1)�?1�1,t•iC'R�7�`n, �� � T� �..�+'�/ti� l.C�'- yI�D�S�7'� <br /> Pmposatl Use of Building Conhact Person (Plan Rev�?w) <br /> CesenptionofWorktoBeDone. !"�l"C^/,/�(�E � C�IS/�NF I��`''� ����/���� �' �C,`/" �-- <br /> �-t�/' t'7-lTl'ILC F�,�'/�/Slt�/J %3`L �7��r��LS . <br /> NOTF.. WIRING IN NON-DWELLINGS IS REt�UIRGD TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLc <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certdy that I heve raed end eramined this epplicetion and kno�v the seme to be We end <br /> co�rect. All provisions olla�vs end ordinances govemmg this type of�rork tvill be completed <br /> u�hafher spoa(od here�n or not The grenting ol e pemvf does nof presume to giva euthonty to <br /> violefe or cencel fhe p�o���!sions aleny olhersfe;e or loca:�aw reguleting construcNon or tha <br /> pedormence ol consfruchon. Thet 1 em eufhodzed by the owner of this proparty to pedorm tha <br /> �vcrk lor which epplicetion is mede and 1 comply wifh the Stefe Conhactors Lew 18.27 RCW end <br /> 296.200 WAC. <br /> .�,�� .1�Y,�--- �y��y�'� <br /> ignalutc Date <br /> �f-��`/ S � <br />