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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FNX 425-�57-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEf'TED FROM 8 AM 70 4 PM �'�5�� <br /> CY � ` <br /> LstUO� �� r� �r I 1/� I.���" <br /> PROJECT ADDRESS <br /> PaC.i-�<< �r� - �ot�_ <br /> C��� rna����. (�uov �� �� . i,U . �v�r��-t , (,�� ���� i��.�- �,�i� <br /> OWnef MailAddress City State2ip Phone <br /> �7Cl.YY1-l', G1.� G1.(�U��� <br /> Tenant MailAddress City State/Zip Phone <br /> 0 <br /> Fl��SU��+�.mS��� ���a 5 P�rk S+ - �����'►a, �►1 �'�4vq 5 a�� g�I <br /> Electri�al Conlral—ctor—� �dail Address City State2ip Phone <br /> /1ZRSV �IC�� I�S � � C�•Dv <br /> Stafe License Number Contract Price of Work <br /> CUY1�Y1'�-i'c:,LGtS� v�� !Ca-�>i� U L�', <br /> Proposed Use ot Building Contact Person (Plan Review) <br /> I� � /l <br /> Description of Work to Be Done: �U W VJ I�l �GI C„ �� �� �n G -I-o r �n 5 t� v � <br /> a d�u.�-t i ��SS , S n i � � S U��-�'-��n a-�-f' W n��- �61�.i n a <br /> �ni �1 ��►� G�c:(v�r �'�E%Yl <br /> NOTE: WIRING IN PJON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereGy certily Ihat 1 have iead and examined fhis applicafion and know fhe samQ fo be true and <br /> correcG All p�ov�sions ol laws and ordinan.es governing this type o/work�vill be complefed <br /> whether speci(ied herein or noL The granting ol a permrt does nof resume to give authonty fo <br /> violafe or cance!fhe p�ovisions ol any ofher stafe or local Iaw reguPting construchon or the <br /> peAomrance o/consfruc6on. Thaf I ar�authonzed by the owner ol flus property fo peAorm fhe <br /> woik/or which application is made anu I comply wifh fhe Stafe Conlracfors Law 1827 RCW and <br /> 296.200 WAC. <br /> �'��'�{�L�� �'-�7_yL,�,C� j � � „��j -D� ,t ds � 1 -I 3 `l <br /> Signature Dale <br />