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�E/13/2�13 �?:?� 253-631-7754 FROJIDENT ELECTRIC r^AG� �2/03 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 320D CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—�»vw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �?A i � 1�l- vV • Lf�r�� 1� <br /> PROJECT ADDRESS <br /> C.�I 257"z!�'s.�-l��l <br /> C,Q�j�12S f � K�k� �v �X 1442� �IIU. L�E�'--tW�4q _ �. <br /> Owner Mail Mdress Gity StatrJZip Pl�one <br /> Tenant Mail Atltlless Cliy S1atPJZlp Phonn <br /> p�1D�7� 'LFLT�tL �A��3?_AOX-1(�� COv1NEjiUN;��i.81��i�•�o3z17sDl <br /> Elr.qricalContractor MeilAddress Gty StatelLip Phone <br /> Y Y_n Vl�L I O��L _ --- <br /> State license Number ConVaet Price of WoAc <br /> �.��IA�--- <br /> Proposea Use ol Building Ce ct Perscn (Plan Review) <br /> Description of Work lo Be Dona: ����v�(ir� �� <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABL6. <br /> ' ��' � �'� 1 <br /> qTY OF EVERETT LOCAL SALES TAX CODE IS 3705 I <br /> 1 nerchy r.eRifylhat I havo iead and exomined this appiicafion and know the same fo be We and - � /� � <br /> concrot �l1 provrsions W/aws and ordin:+nces govemmg this type of work will be completed �, ( „�(.�'G-� � l� I <br /> whethor speG�fed herein ornot. The granting of a permrt does not presumo to grve aufhorr(y to <br /> vrolale or cance!the provisions of any otherstate or local/aw mgulating consWcSon or tho <br /> prrlormanre ol consWchon. That I am aufhodzed by fhe oxner ol this property to pedonn fhe <br /> wo�k/or which applicalion is mado antl 1 comply w�th the Sta7e ConVacf�rs Law 18.27 RCW and <br /> 296200 WAC. <br /> . ' _�_'�,-("L��----- j <br /> Signature -� - - ale <br /> i <br /> 1 <br /> I <br /> — _ __— _ — <br />