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1 � <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETi' PE�MIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everett�va.oig <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I <br /> 2001 /UO I� le- b�� f� � w'A `�� I�X <br /> PROJECT ADDRESS <br /> 4'�,� I C;yl,�rvn Z-oe i loo If I� L=��,e�N � w/ti `��to�' 4L�• 33q. StS�v <br /> OWnef Mall AdAresb Ciry SteleZp Phone <br /> fku�w�� �c���tlfo 1-oa I loo / 4- IE �vr.�cN , w:9 `ia z,X Na.s� J���, sz.s� <br /> Tenan� Mail Addreee Clry State2ip Phone <br /> �� l�k- w�� ��c. ro r-�x �i�� 3 �u,u4. w.4 ��Fn� a�e rt� s�.3 s <br /> Eledficel ConlrBc�of Meil AJdres, City SIe�N21p Pnone <br /> RcA���u� �1ts Jr� �P�•}. Ss _ <br /> Slale license Number Contract Pnce ol Wo�k <br /> c��mi�,����{' _ �ty}� .l��r� <br />� Preposetl Use ol Bwlding ContaCf Persan (Plen Review) <br /> Description o'Work�o Be Done. _ — <br /> ;i��l�l1 c�h�, �- Iw✓ w14a5c b`"�"-� r^�r,— '�' �/�kr-_ <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO rIFEE � <br /> BE IN RACEWAYS, MC OR AC CABLE � � <br /> CIIY OF EVERETT LOCAL SALES T0.X CODE 13 3706 <br /> 1 he�rby crirtdy Ihef 1 have reed ond e.emrnec'tAis appOcalion end know fhe same to Se hue and <br /> conacl All provisrons o/Inws end ordrnences governing th�s lypo o/N�orh will be complefe�J <br /> whethcr specdied herain or not The gnnhn�ol a permd does nof msume fo grva autho iry to <br /> violale or cencel the proasions nI nny ofhe:sfete or locel lew ioA��Pt�ng conslruc6un orine <br /> poAc�mance ol construcfion Tl�af I ern authonted by Ihe ownerollhis property lo pe�fo�m fhe <br /> work la�whrdr�ppGceGon is mudc nnd 1 comaty wrfh Ihe Sfete Confracfors Law iB 27 RCW end <br /> ?96?00 WA �? /i' <br /> I �1 � �i' q, 11- , �� - — ' ��� – j � �, <br /> 7 SignaWre Date <br /> I______._—_—__—_._.—.— <br />