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1 <br /> ELECTRICAL PERMIT AP�LICATION <br /> CITY OF EVERETT PERM�T SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—vwvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> '�..��I �/t�EP 4JaKE �jG1�17 <br /> PROJECTADDRESS <br /> ��7��3L.��/L��L�.- � �'1 /CP /J(c i�r� � c�, �,-j/ �✓i1� / `-' -� <br /> � <br /> Owner � Mail Address C ty Sta�e2ip Phone <br /> `"t�,�;'.��� t ..�: ',� S) •J4 L- : , J <br /> Tenant Mail Address City State2ip Phone <br /> -r:�,�,t..,�_ n�nky ��� �, t-1.r--rq�'r. ��/,q �BIC� ::�'l•-G�e <br /> �i�i�.� S6'qTi'LG' '%Gi'!�' <br /> EleCiriCal Con�ractof Mail Address City Slale/Zip Phone <br /> ) 1--��v�:_f�5 r�J� -Y._t f � ��/ �i� <br /> Stale License Number Contrad Price of Work <br /> r�r"�� ,t� EtvVP�'-b �i^'�e.f-10 <br /> Proposed Use of Building Contad Person (Pian Review) <br /> Descnption of Work to Be Done: %�'�!*l4�`.: f-I N`�L- Cc^1.1�J?�:_'_]'lL`/1 '�'p A �� /�`��� <br /> ;,�- . - , .�,..f, .l, (.� G/RC� ��T ��� v�� rz:y r>YFielr� 1 fc� ,�, <br /> 'i .:/ i/�i`r�/CJP-✓.F-_J-J"1- �I',! ; <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify lha�I have read and examined this applicalion and know Ihe same to be true and <br /> correcl. All provisions oi laws and ordinances goveming this type of w.ork will be completed <br /> whether speufied herein or noL The gran�ing of a permd dces not presume to give authonry lo <br /> violate or�zncel Ihe�rovisions of any o�her state or local law regulating construction or the � <br /> periormance of consiruclion. Tha� I am authorized by the owner of this property tope rform Ihe <br /> work tor which appliration is made and I comply with�he Stale Contractors Law 182 i RCW and //���� <br /> 29G200 WAC. , <br /> i:-� . �� L <br /> 1 , C,�"� /�'����� /i' y L�{� <br /> � o 0 <br /> ` Signature / j Dala <br />