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ELECTRICAL PERMIT AIPPLICATION <br />CITY OF EVERETT PERMIT SERVICES ��-0 6—/a <br />3200 CED,aR STREET, EVEP,ETT, WA 98201 <br />425-257-8610 - FAX 425-257-8857 — �vww.everettwa.org �/O/Z—��1,6 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��GC/ S <br />PROJECT ADDRESS <br />�. ,I <l,�•.�• <br />Owncr <br />Tenanl <br />� �. <br />�i �� � �- <br />i�� � � - ,�� ' <br />f�lail AdAress <br />Mail Address <br />� �=�. �i <br />cny <br />City <br />�. ,� <br />l �,�t�..� � <%Y..1�.� �_;�c:; �t(< <_�, �J ; <br />[leclrical Contractor Mail Address City <br />I .�..,.4.,.. I TS< c �.� <br />Slate Licenso Number <br />Proposed Use of 6uildinc� <br />, t� � � <br />si3�erz�� <br />Stale/Zip <br />Phone <br />Phone <br />rZ Y <br />" ' �z,o � <br />�ezrc�L L..�tri � � �l1 i <br />StalNZip Phone <br />� kUc�. ��. , <br />Conlract Prico of Work <br />CcNacl Person (Pian Review) <br />j[ <br />� <br />Dosr,ription af Work l0 6o Done: i�.�, _ _ � , �. . - � i �-� <. �., I �. �.� . K i , � �c. � :� i � . �. � yt., � � <br />� C i � 1 � `. t_ � , . � �.� � i ��r � � � v� C�i-rt � � inA �✓ �j:.u.}-�'� '��c..- <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />B6 IN RACEWAYS, MC OR AC CAdLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I herehy certil}� fhat 1 h�ve read and examined Ihis application and kno�v the same fo be 6uo and <br />correct. All provisions ollaws anAor<finnnces gevenung lhis fype o! aorh �ril! be complefed <br />�rhether specdieAhemin or noL The yrant6ip o/a permd does nof m sume fo give aulhority (u <br />violafe or cancel the provisions o/ any ofher sfate or local la�v regulating cons6uction or Ihe <br />pe�fo�mance o/conslniction. Thaf I am authon:ed by the onner ol fhis property to perfonn Ihe <br />�rork lor which applicafion is mado and 1 compty �vith O�e Sfate Conlracto�s Laiv 18.27 RC W and <br />29G.200 WAC. <br />- . , <br />-� <br />� � �:._ . � �� /C ��_ <br />-- .`>i;�naWre Dale <br />FEE <br />