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ELECTRICAL PERMIT APPL.ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /, `l C� '1 Z <br /> 425-257-8810 - FAX 425-257-8857—vwvw.everettwa.org `"� <br /> L��zv�(—iD Z <br /> APPLICATION5 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ,5ui f� IU� <br /> _ � .�oc a 3 =ti l� ��. � �-� z���- �v'a - W 8 � �� <br /> PROJECT ADDRESS <br /> '.�- /1- "t�c�',U ' <br /> /r,_ / ( �'�v �P r�-�l�, (' > t(c P/Tw ., f-�, e,,-� �' , � ,s <br /> py,��e� Mail Address Crty State/Zip Phone <br /> y�,: S- �SY_ <br /> s �;�...� �y ��- <br /> Tenant � �—Mail Ad �s Ciry Slate/Zip Phone <br /> ��r vl LC f'. iT ��J � �'. <br /> Eleclncal Contrador Mail Address Ciry State/Z�p P� <br /> �/NU ,E.�r 9io � 3 ���, �'�10 <br /> State License Number Cun- trac�Price of Work <br /> <�- <br /> � � �, �u 7� I � S , =, ' <br /> Proposed se of B Iding Contact Person (Plar�Reviewl <br /> Descnption of Work to Be Done: ��� 5 �ti ta __ G� �f00/t z �n � ✓c r__!�'�-��� 1 '^ s / �`� <br /> GL ��U 4 rM�_'��Xu � � '� /_ 1^.�i '�LL�� `�' '. i� ^ i Cit Cw 7-O '/_— <br /> � gG �I :l VI� O �-�\ - � �`�.' S � T�"� C% �l ��-I v - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily h7at 1 have read and examined this application and know fhe same to be true and � <br /> conect. All prowsions of laws and ordinances goveming this type c/work will be complefed U�(�L�- � J a <br /> whefher spea�ed herein or not. The granting ol a permd does not presume to give aulnonty to <br /> violate or cancel fhe provisions o(any other stele or locallaw�egulating construction or the <br /> perforrnance o(construction. Thar!am authonzed by the owner ol this property to peAorm the <br /> work lor wbich application is made and f compty with the State Contrac(ors Law i8.27 RCW and <br /> 296.200 WAC. <br /> � �..�� y �� � <br /> Signalure Date <br />