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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � _a�_�� <br /> 3200 CEDP.R STREET, EVERETT, WA 98201 �o gd�� a3 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> AP�LICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> ��5`l fi l�-UC.LL�i (�� �'ULl�fi lJi}-��h.�.�� <br /> � <br /> PROJECT ADDRESS <br /> �{-2��� <br /> �,���L �1 L; oC �ca 2�s��-�u.Ct(t( !� (—J��'I{- {Ul� `'I�UI �IJ <br /> Owner MailAtldress Ciry State/Zip Phone <br /> �%t� U 1.�.�1�_v <br /> Tenant Mail Address Ciry Slale2ip Phone <br /> �1U2 �(25 2Sk� <br /> '��u ;ti�L�l�ic �1���re4.n I,�Y� �vex-2N- Lsr�- �3 25c�z <br /> ' State/Zi Phone <br /> ElectriCal CoNractor Mail Atltliess City � P <br /> \ 'I�,� <br /> ���U.L�-hC I�-�t-� `t- �� Y'"l '_ <br /> State License Number Contract Price of Work <br /> \ <br /> LU ��c CL ���,C:1 t-Q��E;��S�� - <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descnption of Work to Be Done�. ��'����Z����� ��� ��1 � ���-1� ��C1� ������� <br /> i <br /> '�v1�1-��`�� <br /> NOTF. WIRING IN NON-DWE!LINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, �AC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> 1 hereby certily fhal 1 havo�ead and ea ammed Ihis applicafion and know fhe same lo be We and <br /> conecL All provisions ol/aws and orJinances govemmg fhis type ol werk�vdl be complefed <br /> whefher specdred hemin or noL The granfing ol a pemut does nof presume fo give aufhonty to <br /> vrolafe or cancol the provisions o�any other sfafe or local law regulating cons(ruclron or(he <br /> performance o/conshuclion. Thal l am aulhonzed by fhe avr.er o/this proporty fo perlomr Ihe <br /> work!or which applicalron is made and 1 comply wilh fhe Sfate Conlracrors Law 78.27 RCW and <br /> 296.2b0 WAC. , - . <br /> -'�, �� ���1�/�� I � �/-�'1�� �) �!� <br /> SignaWn: � - �ate r �1/ � I <br /> _ � �,��, <br /> , <br />