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� . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES s _ �0-�3 <br /> 3200 CEDAR STREET, EVEREl?, WA 98201 j_���) <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org L 13� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> �r� r�� l)�� �/�� ,- �-,Il ( ��� /� �5� , � /'Uo <br /> PROJECT ADDRESS <br /> / S �.(� IUD >�..� �< /UL <br /> �;_ -_, _ � -� ,.,�;�/��•��i �,� ����� U/� `IX�o� <br /> Owner Mail Addross CI State/Zip Phono <br /> � u�ti <br /> Tenant Mail Address City Slale2lp Phone <br /> �'it � ��CPd�/ <br /> 5 (' - t=� � .z.,< i�n� �-_ S� A,,.� w L.,� .,-��,.1� /� � <br /> Electrical Conlraclor Mail Address City Slatc2ip Phone <br /> y1 S�7YS �f�n'�f <br /> �� �/1i� L� I /�n �� �'��1��U o n <br /> Stale License Number Conlracl Price of Work <br /> /✓!- �� `yl,��t n <br /> Proposed Use oi Building Contacl Person (Plan Roview) <br /> y � � � , �� ��� �;�_ �� <br /> Descriplion of Work lo Bo Done: /� �.c.«. /'i �. � " �' + C / � / G� � � � V ` <br /> l <br /> d/ / "� -� , r <br /> ,i� ,_�/7�� TiC G� � � [� - �t� [ C� F ['-c: � �� � � rJ �. <br /> =: .30 ✓ n /� Q � , n yr.a�r.�/ G,i. ��� � ,.,a �. c'-��i� S c c�n^.•� %f <br /> C ii... �.�� j Zi� L L'f C/ o� c i'. S .- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � � �' . �l �i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce�tily that 1 have read and examined fhis application and kno�v fhe same fo be frue and �� � )�`.�"? —'��� <br /> correct. All provisions ollaws and o�r/inances goveming this type o/work�vill bo completed <br /> whefher specified herein or not The granfing of a pormd doos not presume to givo aufhonty to <br /> vio/afe or cancel Uie provisions o/any other stafe or local la�v regulating consWction or Uie <br /> performance o/construction. That 1 am authonzed by the owner oI this property to pedunn fho <br /> �vork lor which app�icntion is made and 1 comply wifh fho Slate Contractors Low 18.27 RCW and <br /> 296.200 WAC. <br /> `� %� , � � � / <br /> Signaturo � ��' 1 Dat <br />