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�_ � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF FVERETT PERMIT SERVICES <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 /> 3500 - <br /> �-�i-f�- �Te�c���ve �vc�l�-�� �/ �-r <br /> PROJCCT ADDRESS <br /> �� �-f" �� � I� U P�P-�f-� <br /> Owner Mail Address City Stale/7Jp Phone <br /> ��� <br /> Tenant Mail Address City State/7Jp Phone <br /> ��U►� 1Mo.i,n-l-�,�l� � P�-+e�� � � �r3�3 � Z�FEI.. ,A.�e w� 9rx�3Y vzs-� 6¢, <br /> EleclncalConUactor MailAddress City I��,t�4N� SlateJZip Phone <br /> -� In S �1 `��a IM 1 � � � 4�0 k <br /> ��, V�1.� ;�i�v � <br /> Slale L ense Number Contract Price o Work <br /> �U�vq�,/�Ilr� . <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description af Work to Be Dono: C �C �Q�1 ��'��"'� � � ��C1 C�'�' ��� � <br /> -J v� s�. �l �l— l.tql�"t' �v\-S <br /> NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. ���f r � <br /> �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 > <br /> 1 hereby certily thaf 1 have read and exemined lh(s application and know the same fo be true and � I Z���� C3 <br /> correct. Afl provlslons o(/aws and ordinances goveming this type o/work will be complefed <br /> whether specified herein or nuf. The grantinp o(a perm�t does not presume to give aufhority fo <br /> violafe or cancel fhe provlslons o/any other sfste or local law mguleting consfrucflon or the <br /> perfomiance o/conslrucfion. That 1 am authorized by the owner o/fhis properfy to peAortn fhe <br /> work lor which appdcafion ls made and 1 comply with the Stale Contrec(ors Lew 18.27 RCW and <br /> 296.200 WAC. <br /> �����--- y��S l�c�(z <br /> Signature Dale <br />