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! <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMI'� SERVICES � _ -, �-�� <br /> 3200 CEUAR STRE�T, EVERETT, WA 98201 r' � � (�.r I ?J <br /> 425-257-8810 - FAX 425-257-8857-wwv.�.everettwa.org �- � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I O�� SZ l�C..f�,2 f�l �_ <br /> PROJECT ADDRESS <br /> St+�(L� L �F� <br /> C�r,u�2--�^��� ���C9 R���(�- a.� c�S�r� rr S'3���► ��.0..� <br /> Owner Mail Addross Clly -.late/Zip Phone <br /> Tenanl A1ail Address City Slale/Zip Phono <br /> kQa�SS ► N E�Ecrc�� c P a.r�-� SyU ��'2� rr ��R 4�53as-�5 <br /> Elecirical Conlmclor Mail Address Ciry Stale2ip Phone <br /> YI�' �!-55�� � ���ZL� - <br /> Slato License Numbcr Contract Price of Work <br /> 1-I-O�S�� <br /> Proposed Use of Building Conlact Person (Pian Review) <br /> Doscription of Work to Do Done: I •,� � ^ � ' 2�� ��TS T �2T I�t't . <br /> (�� �� R� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CP�BLE. <br /> CITY OF EVERETT LOCAL SALES TAX.CODE IS 3105 <br /> 1 hereby cedily Ihqt 1 hnve read nnd e�<nmined this application and know Ilie samo to be Irue and <br /> correcl. All provisions ollaws nnd mdinances go��emmg fhis type o/work will be completed <br /> whefher speciGed herein or not. Tlie granfin�ol n pemuf does nof iosume fo git�e aulhonty fo <br /> viola(e or cancel tho provisions o(an}�olher slnte or local law reguPfing cautrucfion or tho <br /> peifommnce o(r,onsfruction. That I am aufhoiized by Ihe owner o/fh�s property to pedonn tho <br /> �rork!rn�which. plication is mado and 1 comply�rifh the Stafe Con6actors Law 1827 RCW and <br /> 29G.200 WA � <br /> � ` � - — <br /> Si�nalwe ale <br /> � IIU6- (,71 <br />