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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �o ` S_o � <br /> 3200 CEDAR STREET, EVERETT, WA y8201 <br /> .��-257-8810 - FAX 425-257-8857—www.everettwa.org C �q I��D�q <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> 10��� �ll�� �1}'l� S�i . SK lvZ �i�/P�-C"�Y G.st'�—� �0 2G g <br /> PROJECT ADDRESS � � � � z }'� <br /> '7�� _ <br /> 3� 7J <br /> ����)Inl 7"Ht�1CT �031� (���h�E SE� S'�- l02 G/t-��t� (,.�{- �'8 2,oS' <br /> Owner Mail Address Cily State/ ip Phone <br /> S I L i��=.� ca-�K ��v'r l�-� s�J t Sa c� C-A,'-� �,;.r��>` �-�v� <br /> Tenanl Mail Address Cily , Stale2ip Phone <br /> �,;,N r� v2f�N�v �� 7-� - 36,- �4 �z <br /> �'t�r�-�-�"l G�ii� �ui�l�rCr}=�7o �-)s �, o � �c �2-7 _ �--'`! un,� �uc�� . (,.�1�- a S'o � 6 <br /> Electrical Contractor ntaii Address Ciy Sia�eilip Phone � <br /> �E-z-s - 6 7� — ���`� �f <br /> � �� <br /> State License Number Contract Price of Work <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> Description o(Work lo �e Done: I N4�T7�1�l�ATI D�� L�= <br /> � . E�re- C,e-r i l�r�(�--- 1�-q,�j c':-rn.�u r,� �i.: rril-t.l,w 7�r�� <br /> 2 , Z ST3.'� r��-S li� �.�-r �oi� S <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 3705 ���{ <br /> 1 hereby certity fhat I have read and examined fhis applica(ion and know fhe same to 6e frue and �" ' �0_ �l� <br /> currecL All provisions of laws and ordinances goveming this t}�pe of work will Ge completed <br /> whefher speci6ed he�ein or noL The granting of a permd does not presume fo give authenty to <br /> violate orcancel fhe provisions olany ofher slate or local law re,quleting conshuction or the <br /> perfonnance o/construction. Thaf 1 am aufhonzed by the owner of fhis property to per/omi(he <br /> work lor which application is rnade and 1 comply with fhe Slate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,. /u— � —�j <br /> ig ature — / Date <br /> C <br />