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ELECTRICAL PERMIT �PPLICATION <br /> CITY OF EVERETT PERMIT SERVECES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FrUC 425-257-8857 -- .vww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM E .AM TO 4 PM - DEBIT & GREDIT CARDS ARE NOT ACCEPTED <br /> {h <br /> �, S�' _S_�, Ncr�t i� Lo-1- S Z- I . <br /> PROJECT ADDRESS <br /> ZS• j �V�<;,� !c Clee� � � C ��� �vl, 4�oY <br /> Owne� PAail Address City Slate/Zip Phone <br /> Tenant Mail Address City State/Zip phone <br /> `b t ' � �(,v, <br /> I �� <br /> rt ,�; (� � �" 1�r�� �� 4�12t � -7;n�tu �cr l�r ���� ��,,�c,� /,t�c� %�145 � <br /> y }� ;i le � � �, �� , c� i 33�.�;. , <br />(ry s,� .y .. � Electrical Contractor Mail Address City Stale/Zip Phone I <br />' � <br /> f1, ; �ev � ��,ti,e �,� � Ny � <br /> r ,. � ' State License Number � Contrect Price of Work ; <br /> M;•'''�, -:i+ I <br /> t �;'.� �s j � <br /> i-•.'';i`-: ; 1 Proposed Use of Building Contact Person (Plan Review) <br /> �5;,,r � : <br />� r . � <br />� a.. � _ ! 1 <br /> � 7 Description of Werk to Be Dane: � i r��� or:_: ,f f�/�:�2 � 1� I � i SSc cnri��7 �OJ hM p \��Y �,; <br /> i 4 � �� f f 7 � <br /> , ( ��•.�es Tfc.:\of en o(�� PelY�r �� '�z> L��'�- SZI f� <br /> , <br /> :, <br /> � <br /> _ � <br /> '�: .'i NOTE: WIRING IN NON-DWELLINGS IS REQUIREC TO FEE �' <br />''�k`f:' BE IN RACEWAYS, MC OR AC CABLE. ` <br />; r Yio� <br />��� <br /> 1 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certify that I have read and examined this applicafion and know the same fo be�rue and I <br /> correct. All previsions of laws and crdinances govemmg this type of work will be complered � <br /> whether specrhed i;;rein or not. The granting o/a permd does not presume to give;,uthonty to <br /> violate or cancel the provisions oI any ofher siate or Iccal law reyulating construction or the <br /> � pedorma�ce o(construcnon. That 1 am authorized by the owner of th�s property to peAorm the ; <br /> work�or which application is made and 1 comply with I1�=State Cunfractors Law 18.27 RCW and `^ <br /> 296.200 WAC. ; , <br /> ,%k/_�,"���,�jl/�- �� ' �Cl � L� C� �!�1' <br /> SignaWre Date �I�: <br /> t� <br /> 1� <br /> d <br /> /(/����� �R <br /> 7 v � <br />�•' � � <br /> I � � __ <br /> _ _—__—_ <br />> >�_._.. '_—..__. �_ ....__�`w_..� �_.._��—.�......_� . . . .__ : .T � . <br />