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� r <br /> : . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT 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 /> �i�6 Ys3 sf. s_r- <br /> PROJECT ADDRESS <br /> �'s•�ol., ., L. �1���.. 21i6 •��TS St S/� Fu«�f� w/� `�� �o � <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenanl Mail Address Cily State/Zip Phone <br /> C�.:s�:..� �=���!>,-..� l G�3,� �S�O s rY✓� /1F ll�c/".o+.<..��/ G..7� `JPOr 2 L�2r- 8d;- 35 J'7 <br /> Electrical Conlraclor Mail Address Ciry State2ip Phone <br /> Ci�rSCn �C j�� R 7 �7DiJ.oG _ <br /> Stale License Number Conlracl Price of 1Vork <br /> ��'M �7 C I'.�o(c h/� / . <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descriplion of Work to E3e Done: /,�%.r��� �,� ���,;� �<<,l( { ,� �h �f� , h�� <br /> � <br /> /lG:v b�.:G.?.t//�! 5 �^.•/ O�L��R-'.h <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> i BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> I hereby certily thaf 1 have road and examined fhis application and know the same to be true and <br /> conect. A/l provisions o/laws and ordinances govemmc�this type ol work will be completed <br /> whe(her specified herein or noL The granfing ol a permrt does nof presume to give authority to <br /> violate or cancel the provisions of any ofher stafe or local law regulating construclion or the <br /> perlormance o/construction. That 1 am aufhorized by fhe owner oI fhis property fo periorm ihe <br /> work lor which application is made and 1 comply with the Stafe Confractors Law 1827 RCW and <br /> 296.200 WAC. <br /> � 1_- ----� � <br /> — ------ 3 -.&' - 06 <br /> S gnalure Datt <br /> � CCno3 -c�lS <br />