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�LECTRI�CAL �'EaMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8657 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Z ,� _/Z <br /> �`( L�/7�2 —a�(� <br /> /r,���/� .I� Y', S ;t= , <br /> PROSECT ADDRESS 1� <br /> (' �'G PI'z`�/ <br /> J �I��U-SG17 �D � � :�D tk Q ✓� S7' l�'n <br /> Uwner Mail Address Cily State2ip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Conlraclor Mail Address City State/Zip Phone <br /> e. ��. 's rc�'� � ��,� �/6¢,� <br /> State Licens Number Contracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Reviev�) <br /> Description of Work to �e Dona '��J�'�,D l� `� 'l"Y�</ T_�t'�����LL"7` <br /> > <br /> 1 )� L���� � J�II(� �P �CI�Ts��-!S/,, �� �' — <br /> � <br /> � <br /> � NOTE: WIRING IN NON-DbVELLINGS IS REQUIRED TU FEE � <br /> � BE IN RACE�VAYS, MC OR AC CABLE. �- C�.' <br /> '��� — <br /> CITY OF EVERETT LOr,AL SALES TAX CODE IS 3105 <br /> I hereby certi(y fha(I I�ave read and examined fhis application and kno�v the sarrie to be tn�e and i— I?�G _ ��LI I <br />� cormcL All provisions of laws and ordinances novernmg th�s fypo ol work will b� complefed t S <br /> �vhefher spec�/ied herein or noL The�raniin�o(a pernuf does not presume to give aidhonty to <br /> violafe or cancel the provisions olany elher state or loca/la�v re�ulating conslrur,tion cr the <br /> I per(ormancc-o(constructiun. Tfiat 1 ai�;aufhorized by Ihe owner of this property lo perform the <br /> �vork lorwhich application is made and I comply�vifh Ihe State Con6actors La�v 1fJ.27 RCW and <br /> 296.200 WAC. <br /> �Ctt���, ^/'l�/ , � C,� ,�. <br /> � �4 � <br /> --SRjneturo � "�'�' <br /> 1 � <br /> l <br />