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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES - <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425•257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /�D� (�[/Ef Gllol/t �/-P �i[lu��`-C �Uy CJ��I <br /> PROJECT ADDRESS <br /> OWner�, ��!-PK.LI� S O/�sZ2S�`} J��/+�< 0�wily �1.�c K �~I �.� _IJ.�G�p `1dZ ��hone <br /> l <br /> /YI�� /c�Si dPul�P <br /> Tenant Mail Address City State2ip Phone <br /> G 2� ���z �s�a.z rZu��-� �f � �0 2 E��,U �✓4 Ssr�i yz3��a6-�83 <br /> Elecirical Coniraclor Mail Adtlress City Stale2ip Phone <br /> �/zC�L��k Ci �gC 6 /OvU =- <br /> Slale License Number Contract Price of Work <br /> �CC��r�7�1 A � �i ��� '� �� CCYJ K� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion of Work lo Oe Dona �EG'�S/(e� (�fi�1 � � 3 F��v��"i'� <br /> �/1� � / ��,� ��Q�dG�ST�UL N,P/�Y �.1C �'G'Gork�,,-. p — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certil}�fhat 1 have read and examined this applicafion and kno�v the sarne to be We and <br /> correcL All pravisions of Imvs and ordinances govermnc�this type ol�rork will be completed <br /> whether speci6ed herein or noL The�ran(in�ol a pernnt does not reswne fo give authonty to <br /> violale or cancel fhe I�roeisions oI any other sfate or local la�v reguPfing construcfion or fhe <br /> perfom�mice ol construction. Thaf I am aidhonzed by fi�e o�vner ol this property to perfonn fhe <br /> work!or which applicalion is made and I cornply wiUi fhe State Confracfors Law 78.27 RCW and <br /> 29ti200 WAC. <br /> _�:� '=� ���Y-� �d� �fl�� <br /> SignaWre Date � <br /> � oc�o( -Cq 2. <br /> ',���i - i,� <br />