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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMlT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wv�nv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� �,� � � ��r�. 5 T <br />PROJECT ADDRESS <br />'�1S F`ir7i <br />i�l�J� 1����,�1r2 �=�?/ ",}��r ;> l�v;�/'(`� L-J4 9�20) 53a3 <br />Owner M1fail Address City StatelZip Phone <br />Tenant <br />Afail Address <br />City <br />St, te/Zip Phonc <br />( � 7j <br />lr� (k � L.1� C 7�'l� � `'-d �.'Vr+ i �i �i � � i .S�/�Ti � l� LJ �" � (]��� � ��25 b�%G <br />Flecirical Conir2ctor Maii Address Gif, State2ip Phone <br />�K�- �� e: ��`19�/�/M 7 <br />Slate License Nmnber <br />���`� � Oc',V T <br />Proposed Use ol Building <br />Conlracl Price of Work <br />�.v �r �i,�c i�.i� — <br />Conlacl Person (Plan Review) <br />DescriptionofWorkloBeDone: =l.(S"(�-e.L `� FR�.J �z;�c;�U I-1,-rt'Yc°�� �-�17U LJq�_L <br />�{iC,.i_a.17 ;/i�H'm�;�_i,�: S_:��cil_��Cq-i�. Pq/�IttL <br />NOTE: WIRING IN NpN-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereb}• cerTi/y fhaf I have read and examined fhis applicafion and kno�v tf:e sarne to be fn�e and <br />correcf. All prnvisions ollaws and ordinances govemmg fhis type ol worh �rill be complefed <br />whether speci7ied herein or noL The granting ol a permrt does not resun;e to giee aufhonfy (o <br />violafe or cancel the ruovisions olany ofher s(ate or local law �eguPling consf�uciion or the <br />perlormance o/ consfruction. That I am authorized by Ihe o�vner o/fhis property to perfonn Ihe <br />work lor �vhich applicafion is rnade ar,d 1 comply wi(h the State Confracfors Law 78.27 RCW and <br />296200 WAC. <br />!-- — ,'C7 . <br />� SignaWre <br />i <br />-- � _. � /i <br />// _. � C� ' c. - <br />FEE <br />��5� <br />�Gl il - (3U <br />