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� <br /> �g t 7�m <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-envw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> ���0____ l��m.Q.��Ly(�SL 11CL� • <br /> PROJECI'ADDR�S,S <br /> '�n e� Tj��Pi 52t�um 1�'S'�o.� Y2S- Y6� - �r' y3 <br /> Owner Mail Address City Slate/Zip Phone <br /> _.---- <br /> Tenant Mail Address Ciry State2ip Phone <br /> .Seakurs'1- �Joo3 S".,��ti ,�r.-e F�e.�e.77' 'W�4 1�8'�0� y�-r �s{s-6 �7 <br /> Electncal Contractor Mail Address Ciry Stale2ip Phone <br /> S6�{l�c, c .��t96�,v <br /> State License Number Contract Prico of Work <br /> I IC f�5 • <br /> Propos Use of Building Contacl Person (Pian Review) <br /> De�• iption af Work to Be Done: �l/�A+t�(1 � 6 �el' �( ��(( �f ��rUL � O �� 7�0 <br /> � / <br /> �i �r9r��� ti2in N .P.� � S2w� V � ,a2 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ��. o0 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i 7iereby ceRily that 1 have read and examined this appi�oation and know the same fo be true and <br /> correct. All provisions o/laws and ordinances goveminq this type o(work will 6e completed <br /> whefher speci/�ed herein or not. The granting of a permd does not presume to give aufhonty to <br /> violate or cancel fhe provisions ol any other state or/ocal law regulating constroction or the <br /> performance o/construchon. That 1 am aufhonzed by the owner of this property fo perform the <br /> work Por which application is made and I comp/y with fhe State Contractors Law 18.27 RCW and <br /> 296100 WAC. <br /> i� a�� Vi��i.�:ly+� � - ?- `�— o S' <br /> Signature Oate <br /> �� S�3 -/ /J <br />