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ELECT�ICAL PERMIT APPLICATION <br /> CITY OF EVERETi' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-b257 —www.everettwa.org <br /> �—6.5—a c� <br /> APPLICATIONS ARE ACCEPTED FROM 8 r,�". TO 4 PM �� p $D��Z� <br /> ; ,���_C_' a�� r-EI, 1)i'� �v L w t.S i <br /> PROJECT AGDRESS <br /> i'Liv� Cr � i'� � `� t 1 v>: �� t. �•�, ��I� �� ��-- '� <br /> Owner Mail Address Cily State/Zip Phone <br /> I�Cvv� T�.., �+ti�Y�,-. 4�� v�<1- 33i 3 <br /> Tenanl Mail Address Ciry State.2ip Phone <br /> I�, �� , �;�� ;Zw:�- CI�����.��,IS,-���� �' t��3c��� �3�� C��S-k��c� .s ��',�s� 9Z5->j"� y/G� <br /> Electrical Cor.tractor Mail Addmss Cil� Sta�e/Zip Phone <br /> L�i l I IU h'(- � '� a) ��� � `� CC'C� "./ — <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Reviev✓) <br /> DrecriptionofWoricloBeDone: I-�ti��� �) L�'��-' ��yy � �� �` ��'�{i � <br /> ���" �,)�' �+'•'��ti-� :.t�� -rliC�1 I� ��t. ^! V'_P-1 <� /C� ,�7 � `liCiL/ C�G.: i `'CJ��� <br /> ------< <br /> NOTE: WIRING IN NON-DWELLINGS IS f�EQI;IRED TO FEE <br /> BE IN RACEWAYS, P4C OR AC CABLE. <br /> CITY UF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily(hat 1liave read and examined this application and know 6�e san;e to be Vue and p'a� <br /> ccrrecL All p�ovisinns o(/a�vs and ordinances governmg this type oI work�vill Ge completed ,03 <br /> whefher spzu6ed herein or ncL The granting o(a pernuf does not resume lo give authonty to �(f� <br /> violafe or cancel Ihe provisions of any other state or local law reguPfing construchon or fhe � <br /> peAormance oI construc(ion. That 1 am authorized by the owner o/tlus property to perlorm the <br /> work Ior whici�application is made and I compiy�vifh fhe Stafe Contractors Law 18.27 RCW and <br /> 296 200'WAC. <br /> ;� , ';. �;i (I',, � �'- S- C_^2S _ <br /> Signature Dale <br />