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ELECTRICAL PERMIT APPLICATION <br /> CITY OF E��ERETT 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 /> s-, •7 �c�"`` s�. � .= c��= � - ��:..,.� 5_;>�i7 <br /> PROJECT ADDRESS <br /> G�.;:L� i�ti if1; C'.._:.!a <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Mail Address Ciry StalelZip Phone <br /> G�C..�.�%I-/•Gt�(,�-../i��w-CLY�_ "" ��j� � C.<<:�J� J��J. G/YJy�'� J^/.,ul'til, l"y'r %',�',:c.i" J�i)�,���• 7�7z � <br /> , .�; � ElecUical Conlraclor Mail Address City State/Zip Phone <br /> i x�- <br />� � �, /�^_'v:�ci Mr7 %%i/r✓1� � <br /> ' � State License Number Conlract Price o(Work � <br /> � <br /> ,,,y n <br /> � . Jc.">i t�1.. na �Ce�:l�., �JC� <br /> j� �'. �� �� Proposed Use of Building Contact Person (Plan Review) � <br /> � <br /> I� ��. . . �' (�: t--/!-3,P4/ <br />� .,�- Description of Work to Be Done: <br />�° - - <br />� ~ ��' <br /> fr. <br /> ` � <br /> � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> `�e�"c� BE IN RACEWAYS, MC OR AC CABLE. <br />'� , <br />� <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerfily Iliat 1 have read and examined Ihis applicalion and know fhe same to be true and <br /> correct. All provisions ollaws and ordinances governma tlns type ol work�vill be cornplefed <br /> whether specified herein or not The g�anfing ol a penm:does not restune to c�ivc- aufhonty to � <br /> vio/ate or cancel the provisions o(any ofher state or local law reguPting construcfion or the <br /> performance:;lconstruction. Tha(!am aufhorized by the owner of this property to perform the <br /> wo�k Ior which application is made and I compty wilh fhe Sfate Contractors La�v l tJ27 RCW and <br /> 296.200 WAC. <br /> {\'/� / , �j � <br /> ./4 ��L9��,{� / � ��� l�J. <br /> �- SignaWr Date '' <br /> 0 <br /> So�l - o7c <br /> p�.;, _.,, — <br />� :: ; <br /> M ._. ���._,.__.._�.�.. ,.- ...r..�..._....-..,.. . _ _. . ,—__ ` —_ <br />