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� . <br /> ELEC�'RICAL PERMIT APPLIGATION <br /> CITY OF EVERETT PERMIT �ERVICES 6 �,� _ �3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 [-1306�lO� <br /> 425-257-8810 - FAX �25-257-8857 -�vow�.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 .4M TO 4 PM <br /> �� � � � <br /> �, %} z't , /� �i'�� /� ��� ��r�� �� � J/��� l� �J �Gt��_; �e G, � �, s� <br /> ,- -, <br /> PROJECT ADDRESS <br /> ' � ' r / / � <br /> ZG� c1 J P:�!'r �� �t-C � �' c� ✓ fcJ �, -� l��=Yi -�Ur_ <br /> Owner Mail Address City ' State/Zip �Q� <br /> .5 � ' � � �L�/-� � ��� r�.�S <br /> G �1 ;_?�c . C ,b ,�'=v r„�� <br /> )GtMu <br /> Tenant Mail Address City late/ ip one <br /> �d'a°� <br /> i�< c 'r — ��Y� �" c �SG�..2 �- 3S� �vc L!�' L`1+�ticJ°��• �/� <br /> Electrical Centractor Mail Address ciry Staterzip Phone <br /> � S (/����� L �lC��(7:5 '/ ��` 5 O�J � <br /> ' Conlract Pri e of Work <br /> State License Numbcr <br /> , � i < � <br /> �.� /�� -r� (! C � �� �)/'10n � �'�t� <br /> Froposed Use of Bullding � Contact Person (Plan Review) <br /> Description of Work to Bo Done: �lr`d Y / c� � GC d20�- C/ "' c- �" � � �� � <br /> l� � (, Ll�� � � J// l..�/P P6^ fJ ll i O� �4 7 C�i � �`- /-v <br /> /i .,,[ �[' l� � <br /> /Z .S //^C"f �/ A /`C �Q[/ �Z E U "1 J�✓� f-� 1/- �2�t� �i <br /> / �� � �'� �l �'� �o ��, .,� C c' �f-r � �o S u �' � G l� v-C [� /� �l <br /> f,.- c, -„� �� �-. � 1 i� 5'7`: v�� �.��L�r e..� FEE <br /> NOTE; WIRING IN NON-DWELLI�IGS IS REQUIREZ TO <br /> BE IN RACEWAYS, MC OR AC CABLE. I I -7 S C� <br /> � � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r I��/ ' � ,l V <br /> 1 hereby ceRily fhat I have rood and exarnined this op�lication and know fhe samo fo be fn�e and f �F' U <br /> correcL All provisions o(faws and ordinances govemmg this type o(�rork will6e cornplefed <br /> whether specihed herein or naG Tho�rantinr�r'a perrnR does nof prosumo to givo authonty to <br /> violato or cancel the Provlsions o/any ofher state er local law regulating consWcfion or the <br /> peAomiance ol consfruction. That I am authonzed.6y(he on'ner ol fhis property fo pedonn fho <br /> work Ior ivhich applicntion is made and 1 comp�,�vdh fho Sfa:e Confracters Law 18.27 RCW and <br /> 296.200 WAC. <br /> C/� � � � `' t— � � � �� � <br /> Sipnaturo ' Uale <br />