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� <br /> ELECTRICA�_ PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � �ag- �� <br /> 425-25?-8810 - FAX 425-257-8857 -www.everettwa.org G ��� _15� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> c 7 � � <br /> ��%��� �./ � ��•��� �� i� L'�/�C S � �L f /�C'� �'✓ � �� -"r� � <br /> J / <br /> PROJECT ADDRESS <br /> i <br /> �� t <br /> �r'�:. . ���_ ;��,ti,-.�_ ��S i� �% �1�a / <br /> Owne� Mail Address City Stale2ip Phone <br /> � ' �,"�� �,�, , /l �r // <br /> i <br /> �') �. /1%� � / �� � c%t G�7`v' `� �C'vvi^�- <br /> Tenant � ail Address City S:ale2ip . Phone � <br /> /� O � � }' �f/� /, /c' G J , j/c'_ �{ �'��j' <br /> �- C i -�- <br /> � ����, <��'� �-- c l�. �r,-, �- � ,� � � U r„� _�- d,�'� Y���7 a�'� 75� - <br /> Electrical Contractor n4an Address ciry Stata2ip Phone <br /> �`���; - <br /> S�Ni)/- �= % ��i� [�- 3 - <br /> State Licanse Number Contracl Price of Work <br /> � " 7 �1D l. 7�G -�: S �Cj <br /> �j� � -� ) � o` /��'� c' � ���1� 7��c-�,: - � <br /> � Proposed Use of Building j , � Contact Person (Pla Review) <br /> ,L.� � <br /> Description of Work to Do Done: ✓ �n V ' ��� e � ,> •.� �' �- ��' �"`� `' `�� ' " : <br /> • J� <br /> � �� ' - � ��/` - <br /> -r % ( � �, �� . .� � t% ,- i -��,i- �a' ,. � � t � <br /> � t> � � i� %� �� tr L' ..=� /= ✓' vt�. G N,'� tt V7 r' i <-i / /G�-1 <br /> NOTE: WIRING IN NON-DWEl�LINGS IS REQUIRED TO �FEE <br /> BE IN RACEWAYS, MC O�AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 p, <br /> 1 l�ereby certily thzt 1 have read nnd exnmined this application and know the same to be frue and � f 2(� / - � 5�-- <br /> correct. All provlsrons ot laws and ordinancea�oveming this type o(work will be completed <br /> whathe�spea�ed herein or not. The granting ol a permit does not presume fo give aufhonty to <br /> violafe or c�ncel the Qrovisions olany other state orlocal law regulafing construction or the <br /> perfomiance of cons�ruction. Thc+t I am authonzed by the owner of this p�oparty to poAorm t6e <br /> worr'r lor which application is made and I compl}�with fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> - i / / l/ �� � �� i �� ��Z���//�-- <br /> Signalure Date <br /> � <br />