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#� 6�u9µz. <br /> � � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> ,C i E� A�d # sz3 � <br /> / D l o� �vz,�y rcea l,�lay �"►.�� 9��b f�. <br /> PROJECT ADDRESS <br /> ��I� �.� :� sz3 i <br /> Owner MailAddress City State2ip Phone <br /> Tenant MailAddress Ciry Stale2ip Phone <br /> Id � tC���l-� Ele�b-,� so�r 3�U� A�� � S'a..,-+i'k r,.y4 ►Y13 y z�b�bz- <br /> Eledrical Contracl Mail Adtlress City State/Zip Phone 331! <br /> 1�1 ��1.�`E* S�z IC G <br /> State License Number Contract Price of Work <br /> �Jt� VVI IM2JC 1�r� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: i �°V�Vl� I 4�o✓' � f�v�r�z. � � ' � �,/t G ti�� T S �/1" <br /> L -`-��_'y'�-r.r C:� �h�+i I c✓ l..o ��V� L Co�n� I..S S� f f.v� c� <br /> C�iCi \�lL`� �\.1`��e ��T!'�e't <br /> NO"fE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 3 s . �o <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceAify that 1 have read and examined this application and know the same to be M�e and <br /> correct. All provisions o(laws and ordinances goveming this type of work will be complefed <br /> whether specified herein or not. The granting of a permit does nofp resume to give authonty to <br /> violat�or cancel the provisions of any other stafe o�local law regulating constnrction or the <br /> peAormance of construction. Thaf I am authorized by the owner o/this property to peAorm the <br /> work for which applicafion is made and/comply with the Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 64�.. ��,,,,,..�r-- 31 ZS /o � <br /> Signature Date <br /> � d5a1-o G3 <br /> > <br />