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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> 1L <br /> FOR,iJECT ADDRESS <br /> Owner Mail Address city State2ipP <br /> 47-Is Lk93 1223 <br /> iLAIn gbl\,% SCSI) 5 u LEA R%W-S <br /> Tenant Mall Address City Slate2lp Phone <br /> LkzS low -?Sol <br /> 'lMf\ri ] \Ori';`"c Rb likof WS3 \.. V, U A Wh Ci <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Z�1tJ ori EI.�SSK� Z lS .QO - <br /> Stete License Number Contract Price of Work <br /> r"r1V1L4% (k'C\ysG <br /> Proposed Use a ull,ling \ n Contact Person (Plan Review) <br /> Description of Work to Be Done: ��ww &',%k\i\`Q t.)A\vy\ -ilQr \'V\fAV�I L a kLt.r k\AA � <br /> eqw VMLQ u\a , Ll5\(.0(4 �t ave>� A\Aa ,UQV A S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. v' <br /> W <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 horeby cortily that 1 have reed and examfned this application and know the same to be true and � vl — L4 Z <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of s permit does not ppresume to give authority to <br /> violate or cancel the provisions of any other state or local law regufating construction or the <br /> pe"0rmanr•e Of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the Slate Contrac' .s Law 16.27 RCW and <br /> 296.200 WAC. <br /> ignalure Date <br /> C <br />