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_ � <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 1� �ao �(� <br /> APPLICATIONS ARE ACCEPTED FRUM 8 AM TO 4 PM C�Cr7 l�`II� <br /> � T/, <br /> I �'G���, I�1 � /9�'(� fC �,°�y �o� <br /> PROJECT ADDRESS <br /> L�,//, 1;, �;�;; � -�L�,�<- s. <br /> Owner � � ail Address Cily Stale2ip Phone <br /> �Jo✓ �7�Y UP.7 /cr/ <br /> Tenanl Maii Aduress City State2ip Phone <br /> /��S �(f-�7�1� T 1i j��X /y/Z if/;4r�>Sv,�/� c✓%I `3d'1 ;d (��'4�l S7/l�/ <br /> Eleclrical Contractor Mail Address Ciry State/Zip Phone <br /> �� <br /> I -�� <br /> �St �t � � v�� v�J_ 1 ; - ) , j7, ZUO <br /> Slale License Number Conlract e of Work <br /> !� ��Y l r�: f/C(r1 // �J/C/J C /D <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Dr,scriptionofWorktoBeDone: /�v, �� ��d/ %i�i�.� i SOCir�� 2r'/p�'�� �oUf� <br /> . <br /> 'iU�,r��. �� -�!� oOG"%�p�, 5�✓� "f"� �PS� �liJ�17 ,r��. E� ��,u <br /> �� � ' /—�_'�'— <br /> NOT6: WIRING IN NOP!-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i? <br /> ,; �- <br /> i ' <br /> CITY OF EVERETT LOCAL SALES 7'AX CODf IS 3?0;; <br /> !hereGy certify fhat I have read and exantined ihis application and know fhe same to be true and <br /> correct. All provisrons olla�vs and ordinances governu�g fhis type ol work�vill be completed <br /> whefher speci(ied herein or noL The granting o/a penmf does not presume to give aufhonty fo <br /> violate or cancel fhe provisions olany ofher sfate or locallaw reguleting consfruc6on or the <br /> perlormance o/construcfion. Thaf I am aufhonzed by the orvner o/fhis property to perfonn the <br /> wo�k lor whicl;application is rnade and!compl�ifh fhe Sfate Contractors Law 18.27 RCW and <br /> 296200 WAC. <br />� —� --' _.-/ <br /> : /� i. <br /> _� `' ���' ;%/� �j�.�.�-- //- j D (7�% �,, <br /> Signature - Oate . 1 I I <br /> L�I I <br />