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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 425-257-8857-v�ronv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FI:OM 8 AM TO 4 PM <br /> 2204 �Ncl< �r �}vz. <br /> PROJECT ADDRESS <br /> D �n B�r�Soi� 2<08 ('NcKz,i- Avc'. Cv�l-ztt , VVA . i8�1�1 `t15�� ��7 � �dG66 <br /> Owner Mail Address City 3tate/Zip Phone <br /> N � �} <br /> TenaN Mail Address City Slate/Zip Phone <br /> ^S <br /> ��1n��e,r � I �c jr� � ��i-v� « � Ji r� N L I 6rh �r EV�I��1� , 6'Vi9 5b�1ri711 <br /> Elettrical ConlraCtor Mail Address Ciry Slate/Zip Phone <br /> �RivD� eS `i `Ii Gc �j�� ��- :4 . '+� <br /> Slate License Number Conlracl Price of Worl� <br /> �� nqi � f� m � ly K��� Styn ����I�m� �� <br /> Proposetl Use of Building J Contact Perso� (Plan Review) <br /> � <br /> Description of Work lo Be Done: -� �� ) I �� I I I r�� �j Nl '� ��l I ��� � t (J I <br /> NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CASLE. ��5 , O U <br /> / <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf I have read and exammed Ihis applicalion and know fhe same fo be We and <br /> correcL All prowsions o/la�vs and ordinance�goveming fhis type ol work will be complefed <br /> whefher specilied herein or noL The granting o(a pemuf doos nol presume fo give au(bonty fo <br /> violafe or cancel Ihe provision�ol any ofher sfate or local law regulafing construchon or fhe <br /> p�rformance o/cu��struchon. Thaf 1 am authonzed by tho owner o!(his property fo pedorm the <br /> worklor which appi�ation is made�nd I con�ply wifh fhe Sfafa Contractors Law 18.27 RCW and <br /> 296.200 WAC. ; <br /> ���vL`fi� , :� ;'�G � �'L l ti' � � � � � �� <br /> Signature Dale <br /> � i� �'U(c - IL`� <br />