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f, <br /> E�.ECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wwvv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ?;-l_'; U�or�rr �,'�i P Q �°T� <br /> PROJECT ADDR S J <br /> PI)ft f Na t f ix<<� � i �c �5'qi0 2A�A�(p L✓ ��02 L�ititiwao� W4/9A03G Y2S`• 77S•9SSy <br /> py,mef MailAddress City S�atelZip Phone <br /> Tenant Mail Address City State2ip Phone <br /> Frrr ' i I I� J�'� PO 6nx126hg m•ilr��Pk WA/9R082 4Z.S5'Og�9'�b <br /> Eledrical Contfactof Mail Address City State2ip Phone <br /> i rrr' r ' oti6 M r= �� ODO.DO <br /> Stale License Number Contract Price of Work <br /> �is1.i�� t /�n ��v Nr�i�P /'I �a,.� tePr� �✓ <br /> Propeged Use o(Building Contact Person (Plan Review) <br /> �escnption of Work to Be Done�. n I F i. t � nn' S 1 r � � f��% �/' � �G! �^'�C'`i � /NS���i <br /> i <br /> � ,,, � J�. ,{ ,�� , I�I�n 1� P l� � T-S. T�I� <br /> , <br /> v' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREC TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certity that I have read and exemined this application and know(he same fo be We and <br /> corred. All provisions ollaws and ordinances goveming this fype o(work will6e completed <br /> whefher specified herein or not. The granfing o!a permd doos not presume to give aufhority fo <br /> violafe or cancel fhe provisions ot eny other sfa(e or Ixal law regu/a6rg construction or the <br /> peAormance o/consfnicfion. That I am authorized by the owrrer of fhis property fo pedorm(he <br /> work lor which applica6on rs made end!comply wilh tho Sfa(e Con(racfors Law 1827 RCW and <br /> 296200 WAC. <br /> , � i'� it <br /> � . .� . , . " 1 .�� � � <br /> l : r ' , . <br /> Signa ure ' � Date <br /> Ed6o3-c��f�E <br />