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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERV'ICES <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 />° i� «-�r,' Ti� c-�e_' /. = <br />PROJECT ADDRESS <br />/�- -6 --0`7 <br />`Gp%lZ 03.� <br />¢�� '� ,� J — <br />�t� �-�= _= /'/r-•i -�Z �� c: �i.' 7 c�' ;.� ;.-c-[�.< . r= v.-��r;�" ui�J 9R �° c3 r- 65 7 <br />Owner A1ail Address Cily Stale/Zip Phone <br />Tenant <br />Mail Address <br />Cily <br />Slate/Zip <br />Phone <br />i <br />f�L� i <�. S �-c_i.:[� �.;i/ : G�C� .:�_�:ct /Nf_���.%t i.�ilr� %F-.'S%E� .aE.L"�C.�Z' —4 ' L, <br />EleCtriCnl Contrador G7ail Add�ess City Stale/Zip Phune <br />G /! - !� ��-f <br />Slale Licensc Number <br />i=A/ �/G-�i�� /S/f r/^ <br />Proposed Use of Duilding <br />Contracl Prico o( Work <br />Conlacl Pcrson (Plan Revicw) <br />Descriplion of Wor!: lo �e Done: : c' C: /� .; r: �.' �.. , L .r �" /�: ; �� ,�� ! ir�t/! <i• i� ' <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />6E IN RACEWAYS, MC OR AC CAI3LE. <br />CITY OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily Ihaf i liave �ead and exarnineA(his application and know fhe same fo be tnie and <br />cai�ecf. All prowsions ol/aws anAoi�iinances governing lhis fype o/ work will be complefed <br />whether spealied bemin or noL The granting o! a pernut dons nof uesume fo give authonty !o <br />violafe or cancel Ihe provisions ol any ofher stafe or lecal law regulating constn�cGon or fhe <br />pe�formance ol cunshucbon. ihaf ! am aufhorizeA Gy Ihe oa�ner o/ this property to peAonn fhe <br />work Ior wlrich applicnfion is made and 1 comply �rith fhe State Confracfors Law 1827 RCIN and <br />296200 LNAC. <br />,- ,; , <br />- �- ;'`-- ���-i-�rf-Y_�:.tr�-c ii_� /'- i�- ; <br />FEE <br />j�,) - 3��_ <br />