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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE� <br /> 3200 CEDAP. STREET, EVEREIT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org a �/a—� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �����„7� <br /> � I �I 7 ��-l. � � <br /> PROJECT ADDRESS <br /> � <br /> �ell� M; c��,� ll �si � � s�` S% r,,..�.-c�( (✓� �>��:>> <br /> Owner Mail Address Cily State/Zip Phone <br /> ,� c'- CT ���-�e� �.✓A 7�.�G'-3U,--Is7 <br /> Tenanl Mail Address Ciry State/Zip Phone <br /> �,-1� -�/� ZS3 -3 7� -� �/6 <br /> (�I CC `�G-� 5 I y � a� (�lohe�c- c ��� � j�G,I un c,.lA ��' 3 77 <br /> Elec�ric21 Conlraclor MailAddress Ci1y � Slale/Zip Phone <br /> 1� <br /> �«� I �S�f3 Sl/ P3 -��ti'� � 1, 8�c� <br /> Slale�icense Number � � Conlract Price of Work <br /> �,�� L�I=C'�.� �`' - i/� / IC'<�1Nc/P�� NC ��'-� <br /> roposed Use of Building Conlact Person (Plan Review) <br /> Description of VJork to �e Done: _ / � C f {� <br /> NOTE: �NIRING IN NUN-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 hereby certi/y thaf 1 have read and examined O�is applrcation and know the same fo be true and �f 0 <br /> FO� 17 -0 <br /> correcL All provisions o/:a�vs ano ordinances governing fhis tppe oI work will be complefed � <br /> whether speci6ed herein or nol. The gran(inc�ol a pernnt does nof presumo to give atdhonty to <br /> violate or cancel the provisions o/any other state or focal law regulating consfrucfion or the <br /> peiformance of consVuction. Thaf 1 arn authonzed by the owner o/this property fo perfomt fhe <br /> work(or which applicafion is made and 1 comply with fhe State Contractors Law 18.27 RCW and <br /> 296200 WAC. <br /> ; � + '� <br /> ����" ';�C^'2 tilL'Z�!�� /z�p /(J � <br /> Signature ate � <br />