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�. - <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 7- 'a3�/0 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �/00 2/03 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .�i"1 ,�� - �1 <br /> _ , i ��>;� ����,_•� i�,'rc r ;�� �'D -Sr ��7= 1� <br /> PRO,;ECT ADDRESS <br /> 'c�c r �� �SL(� !��0.S lJ�J S�rt/��1��Ai�7�1�LQO�ID� /.ti tN�u Aia i �lf� �7���'d� ylt•s s7•7 �'� <br /> Owner Atail Address City Stale2ip Phone <br /> ���4//.� �-i�lC�i��6LCr1irJ i si`/C 6!hiRr�C ('e.✓Z'R �C A;I:K/Ci77G' c✓�a Y�3✓�S yli"Y`!.3-C'C,i4� <br /> Tenanl �1ail AdAress City SlalelZip Phone <br /> �'ir7e'ihTE^c[y! �n1i I C� injh ;'�k 17ieu,�r(.+.ei �"�C.9eo- �,t,�t� '1D��43 `/li=))-J�.y.�e3 <br /> C-lecirical Conlraclor tetail Address Cip� Siate2ip ��vne <br /> lI�l��i�1J- d '/4^ YA,',C / ��� . . <br /> Slale License Number Contracl Price of Work . <br /> ��c �i�rc�.c,+.�- ��Cr.� ��u�'d�-�� <br /> ProposeJ Use of�uilding Conlacl Person (Plan Reviav) <br /> DescriplionofWorkto6eDone: _- •/".t,�-, .. 7-i f� t��/���i � ��..'1�.,� -rc, /N�'�;Cj'��PI� <br /> .� <br /> -J i l /'�i(�LJ6[� :— <br /> . \ <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> f3E IN RACEWAYS, MC OR AC CABLE. <br /> CITY Or EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby ceriily fhal 1 have rend nnd examined this applic�tiqn nnd knom the same fo be true anA <br /> comecf. All provisions ol laws and orclinances govemmc�fhrs fyp�ol wo�k�rill Ue camplefed '� <br /> �t�hefher specified heiein or noL Tlie c�ranfin�u/�perrnd does nof/nesume fo give authonty to / �_� <br /> violate or cancellhe �rovisions o(mp�ofher sfate or/oca/In�s rec�u ating construclwn or the I � <br /> perlomiance o/consEuction. Thaf 1 am aufhorized by the o�rner ollhis propeny to perfonn the O�� <br /> ivork lor�rhich application is ntade�nd I compl}��vifh fhe Sfafe Contracfors Lnrv 78.27 RC W and � <br /> 29G.200 WAC. <br /> � , i � <br /> )) � /� <br /> �_ � �/i � :-�� C -1 j -'/C; � " I .i <br /> ' Sipn;i�mo � Un�a �. <br />