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���������'�--��LECTRICAL PERMIT APPLICATION <br />� � �-"�CITY OF EVERETT PERMIT SERVICES <br />1 DEC 2 2 2��`-' 320C CEDAR STKEET, EVERETf, WA 98201 <br />_ . ......._.... ......., <br />525-257-8810 - FAX425-257-8857—www.everettwa.org <br />Cflnrnr c r� 9 �P i hf r, gR E Tr , <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PIN <br />I c� /1 <br />�-� U�- C �� � Vt C'.a� V°L� OLti/'%'� i l <br />PROJECTADDRESS I <br />�ii <br />�_ ,_ c- ._„ �� _r,.�_._� �,...,, �-. _,� <br />Owner <br />Tenant <br />Electrical <br />,� '" Mail Address <br />Mail Address <br />, S<<����-� ���S�P�,�� <br />if Mail . ildress <br />t- v C R- ��5..�. I 1"L �2- <br />State License Number <br />CovVl Jvt.Q, i' i�f r�'` <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />City <br />City <br />,J�1, `)' � ? �'- 3 <br />Slate2ip Phone <br />Stale2ip <br />��e�.�,�f- <br />Slale2lp Q�i�v3 Phone <br />I <br />� � S �C�_ UO <br />Contract Price of Work <br />VILIL I ��lvl S _ <br />Contact Person (Plan Review) <br />_Od i ��ro c� • 1� <br />FEE <br />��/�. y'� � <br />1 hereby certi(y fhat l have read and examined this application and know the same to be true and � —� �'`�' <br />correct. All provisions oflaws and ordinances goveming this type o(work a411 be complefed ���`� � <br />whefher specified herein or not The granting of a permd does nof presume to give aulhonty to <br />violafe or cancel fhe provisions of any ether stafe orloca/law regulating consfruclion or fhe <br />pertormance of construction. Thar ! am aulhonzed by the owner ol fhis property to pedorm fhe <br />work !or which application is made and I comp/y witb the Stale Contractors Law 1827 RCW and <br />29E.200 WAC. <br />> �� � /� <br />� l,t,� -v% ,1 c � , �"t � � Z/.? U/L� <br />� <br />� Signature� te <br />� <br />