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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREI'T, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �j�—lI � IZ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �I� S�DG � <br /> �i�lC�l � ��' �lu� 5F <br /> PROJECT ADDRESS <br /> LM 5.:,�d4�o1�, P��,�S�c- l�o��^ HiS�A,�,o� w� qdav� <br /> Owrsr tdail Address City SlatelZip Phone <br /> �u:+ar� �ix�cs lolol Iq� /� SE Fur�e� � ��� <br /> Tenant hlail Adtlress City StalelZip Phone <br /> CFN1 Nea.�; 1 i � �o�(�n D �v 3�c, �verN(� �I.Jf��OE3 �125-6'Z!•IZs3 <br /> Eleclrical Contraclor MaiP tltlress GIy State2ip Phone <br /> CFN1t�F FNl`l53 c`�S `� �0� <br /> State License Number Coniract Price of Work <br /> orc,«: <br /> Proposed Use ol Building Contact Person (Plan Review) <br /> Description of Work to Be Done: —1-1'15'1 Ci � I I 1�1�i.✓ l N�✓/i�D��1 C� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �j����� <br /> l� --- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily Ihal 1 have reed and ezamined Ihis application and know fhe same to be I�ue and <br /> wrrecl. All pmvisions o/laws and ordinances governmg fhis lype o/work will be complefed L I -7 (���_ ��Q <br /> whelher specilied herein or noL The granfing ol a pemu(does not resume fo give au;hority fo �,_ `.v r� <br /> violafe orcancei the provisions o/any other sfafe o�local la�v reguPhng construction or the <br /> peAormance o/construclion Thaf I arn aufhorized by fhe owner ol this property to pe�fo�m fhe <br /> wo�k!or which applicalion is made and I comply�vilh Ihe Stafe Conhactors Law 18.27 RCW and <br /> 296.200 WRC. <br /> . . L.f� / //�L�LG��C..i V��(I—I/ - <br /> ignalure Da�e <br /> � <br />