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�an 03 06 ❑2: 3Dp Rction Electric 3606538534 p. l <br /> ELECTRICAL PERMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3"tU0 CEDAR S7REET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �,4- :� � � L�4-�', I�\- C. � `_ . <br /> PROJECTA�DRESS <br /> ��f--�-� LC'.�SG:`. ���'�l �L';-�l V��'v e ��� � �e i�'-4-� �:Y ' �l � `� \ <br /> Ownef Mail Atldress Ciry State Zip Pnone <br /> Tenant Mail Address Ciry Stale2ip Phone , <br /> ! n �jic(+.�.<-� <br /> C��i l;4-1 ( i'l�f'� i=+'I�XSi� 1r i (i I^LX �C��.Z t�l''.'iS� i1�� U�L t �I a��� ��4=5`i <br /> ElecViwl ConlraUor Mau natlress City �State2ip Phone <br /> C^.�,ls'�� 1 � � -l�� -�-�—� c��E�%� . ��C, <br /> Stale License Number ContraM Price ot Work <br /> 1��5��c�,��h�� <br /> Proposed Use of Building Contact Person (Plan Reviev+) <br /> ��'�1�'t"�`1 � <br /> DescnptionofWorktoBeDone: (• !� �3L1 l:� C'v � Y"lC:_.+'��i� -' <br /> NOTE: WIRING IN N�JN-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. _� C � <br /> ����� �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herriby certrry thaf I have read and examined dris application and know the same to be true and <br /> correct. Ali provisions o!laws and ordinances govemrng fhis type of work wilf be completed <br /> wbefhu�speci(ed herein oi rtot The granting o(a pemrR does not piasume to give authonry to <br /> violate or cancel fhe promsions o(any other slafe or locallaw rogulating conshuction or the - <br /> I pedormance ol const�uction. 7hat I am authoiized by the owner o/lhis p�opedy to pedorm rh= <br /> work 70�which application is made and I comply with the State Contractors Law 1827 RCW and <br /> 296200 WAC. <br /> � � )� <br /> .��t'%1�t-�V'�� • :i'— 1 ' '�'c.�/ <br /> S�gnature t Oate <br /> i <br />