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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425257-8857—www.everettwa.or9 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ]4`"LJ U r R� D �oT=Z <br /> PROJECTADDR S <br /> T7T1R ���TFR A7�SEs in�t- IRN/0 2R�A�/pl✓ �'�OZ �iti�vcuoecQ Wi4/9f1D3G Y2S`• 77S-9SS'/ <br /> Ov+ne� Mail Adtlress City State2ip Phone <br /> Tenant Mail Addiess City Slate/Zip Phon? <br /> Fe�� ' iEl � �r'r PD6ox12L6g nillrr�vlC WA /9ROE�2 42.55�0&�`T76 <br /> Electncal Contfadoi Mail Address Ciry State2ip Phone <br /> �rr�' e � Q,�L M �: _ � �.�, DOO.00 <br /> State Litense Number Contract Price o�Work <br /> �;.���r Fqr, ��Y Nov�� �a.0 te�r�.✓ <br /> Pw ed Use of Buildi g Contact Person �Plan Review� <br /> DescnptionofWorkloBeDone: ��p �•� ( �n1ST�rUG �•�0 �✓ � ��!-����� ' lNSr��� <br /> 1,�=t�.� �v� �Nn �, P /rv / r-� T�� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceAify fhat I have read and examined fhis apWicatinn and krrow fhe same fo be true anU <br /> corred. All provisions ollaws and ordinances goveming this type ol work will be compieted <br /> ��vhefher specified herein or nol. The granting ol a permd does not presume to_r.ive eufhaRy to <br /> v�olafe or cancel thepr ovisions o!any Wher stete or loca/law regu/eting consfruction or fhe <br /> performanoo o(constrvction. That I am aufhom.ed by fho avner ot tl:is property to pedorm tho <br /> �vork!a which appLcation is made end I canply with fhe Stafe Corrtractors Law 1827 RC W and <br /> 2i�6200 WAC. <br /> /�,���,�,�r �� g 6 <br /> Signa ur Dale <br /> � �Go3-af3 <br />