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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIrES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> //C��/ / 9 '`' � vr s.i_ . <br /> , ���/1� Ti (�/-� <br /> PROJECT ADDRESS <br /> ,/�rs. 1K1ClQS cOi�/'. <br /> Owner Mail Address Cily State2(p Phone <br /> �',�, ��� <br /> Tenant Mail Address City State2lp Phone <br /> ✓�dl.Ui=2 GL�Ci��cc /3�';�s �/r`' Au�_. N.r %���� caJ� ��Z�i C3�a�65!-Zi92 <br /> EleCtriCal COrilraCtor Mail Address City Slate2ip Phone <br /> �^l l / �C/ V V f� <br /> rA-�`".,��'�'--�,-�„-_`� Pb�t�i=Rl�� `�`�(l�5 <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Oescriplian of Work to Bo Done: �P��-� C� f���S L�����,�T ?j S/J 2�C,,/Z U (/ <br /> ,p LV%f'/!7C>- /�C .fIL v.i S-�ct��. <br /> NOTE: WIRI�'G IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN '2ACEWAYS, MC OR AC CABLE. � <br /> CjZ <br /> CITY OF EVER�i"f LOCAL SALES TAX CODE IS 3105 <br /> 1 liereby certify that I l�ave reod nnd examined this application and know the same fo be fr�e and <br /> correct. All provisia�s o(laws and ordinances goveming this type ol work will be complefed <br /> whether speciGeA herein or not The granting of a pennd does not presume fo give authonty to <br /> violate or cance/ff�e provisions of any ofher state orlocal law regulafing construction or the <br /> perfonnance o/construcfion. That 1 am authonzed by the owner oI thls property to pedomi the <br /> work lor which application is mado and 1 comply with tho State Contrac(ors Law 18.27 RCW and � �/ <br /> 296.200 WAC. — / O() � <br /> �_ '--- <br /> - �- ---� �� �� 2G��� <br /> ��re `� Dal <br /> `-t-_-=�� � � <br />