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f ' <br /> ELECTRICAL PERMIT APPL�CATION <br /> CITY OF EVERETT PERMIT SERVIrES <br /> 3200 CE�AR STREET, EVERETI, WA 9820 i <br /> 425-257-8810 - FAX 425-257-8857—www.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br /> i I�1i5 S�vi�ci �-Ai<F ���✓t- Cvc�r 982ufr <br /> r <br /> PROJECT ADDRESS <br /> H-41s-337-5yo3 <br /> 3'- "SAO'��h � �it�..7.�`I�i� i�`li< <.i�-.�k.A U�✓£ T'Xi rc✓L•`YCT i �//9 9�ZuG L�- 41.�'SSG-416'i <br /> Owner Mail Address City State2lp Phone <br /> Tenant Mail Address Cily S�a�e2ip Phone <br /> O�,.l �livfl <br /> Electrical Contractor Mail Address Ciry Slate2ip Phona <br /> State License Number Contract Price of Work <br /> �tSS�7�t�I G��.��.i�l.�.-'��vl� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ��i� y�A ��4ov �iz�vz-� �� �ixSs��n��. i'ar����- Ru=Z� Fo;� e.-C�Ti�,� <br /> >`���� �SZ�L��Pc..ir�u 6,AL S'�U��• I>D"�� LJl3-Iz�� ci"ic,��� �G,Fc�.-t'nuTfirT2���'u Ex�s�iNa ('ANc� <br /> F�� -NJ NIi�J Ov�f�iS +-h� LAnA�iL. ADn �5�'12aY CZRc.NT 'Ri f�3-y�11v� I�RN�iL FJrl TuJ Ni�U <br /> ��2��1i i�-riA �N�Gv-1�� - 1 Z�J [.ri���� /a7T.u--�S i;��+3s� , b� \ tN G�fVh�lc_ xlS�i1F'� 3 �^�-7SS <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 /> I hereby certi/y fhaf 1 have read and examined this application and know the same to be true and <br /> correct. All provisions ol laws and ordinances goveming fhis type o/work will be completed <br /> wnether specified herein or noL The granfing�l a permd does nct presume lo give aufhonty to <br /> violate or cancel the provisions o/any ofher state or local law reguleting consfrucfion or Ihe <br /> peAormance o/consiruction. Thaf 1 am aufhorized by the owner of this property fo perform fhe <br /> work/or which applicafion is made and 1 comply with the Stafe Confractors Law 1827 RCW and <br /> 296.200 WAC. <br /> `��� �. �� �I3IOS <br /> Signature Da�e � <br /> �� :�� � <br />