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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 1���— ►2 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��uJ({-o3Z <br /> 425-257-8810 - FAX 425-257-8857-www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l � .��I /ivclCc2 �� r �wc� �7��Q I <br /> PROJECT ADDRESS <br /> \;,/i.e l�'17�'d^� 1 � �`7 �/c!� f1<< �✓crr/j� (,✓/�' `i'�'�O1 <br /> pµme� Maii AdAross Clty StatelZip Phone <br /> Tenant Mail Address Gty Statarzip Phone <br /> �'e S% Q�� s��-.f �-/� <br /> Eleclrical COnUaclor Mail Address Ciry Slate2lp Phone <br /> �sr r3/�s � 3�5r �oo�oo <br /> Slate License Number Contracl Price oi Work <br /> . <br /> ��S�lila�i� <br /> Proposed Use of Buiiding Canlact Percon (Plan Review) <br /> Description of Work to Bo Dono: T � S�i��0 �C�j�� ' �n'PU�G"C � ��x <br /> � ^� /�Z S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �oG� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 31D5 <br /> 1 hereby certify fhaf I have read and examined this application and know tho same to be true and � Z <br /> correct. All provisions ollaws and ordinances goveming this type of woric wil 6e comp/efed � �2 � �� <br /> whefher specified herein or noL The granting o/a pormd does not presume'�give aufhonry to <br /> violate orcancel fhe provisions o�any ofhersfafe orlocallaw regulating construction orfhe <br /> peAomiance o(construction. That I am autho�ized by fhe owner o/this property to pedorm fhe <br /> work/or which applicalion is made and 1 comply wifh the Sfafe Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> , �, � �f ( �of3- <br /> Si nalure Dale <br />