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i <br /> ELECTRICAL PERMI� APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—viww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ' o <br /> ��) � �— ,1 i li_V'P.1 ����, <br /> PROJECTADDRESS � � <br /> Ownef Mail Address Ciry Stale2ip Phone <br /> �t/� l �'�Vl ��{ ,t��l') c11 ��� <br /> Tenant � M il Address City Staterzip Phone <br /> � <br /> /� � <br /> �i i�ri Ur�����n �v r��.l�� ��r ;���,r���: 17N�� r��-Au��� �o ;��rt�N� ��A �l�(� - <br /> Ele !n�ctor Mail Ad[1reTss,J C!y Slate2ip P,hpne --� <br /> 1 , ��� � <br /> �i(; �Y2V'->�^',��kS , I �5-�� �='S` S <br /> Slate Li� cense NOmber - Co t�act Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> I _ _ <br /> : ) � �� -� ', `/ �,� <br /> Descnption of IfJoik,o Be Uone: L � � �� � t � (�i �� 'J ' � %L'�1 i-�' `- -� '. /1 , � <br /> �!ll�-�f� ���l � / � `� l � — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> �E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 he26y certily fhaf 1 have read and exarnined this application and kno�v fhe same to be true and r�r-��_`��Z <br /> coirecf. All provisions o/laws and ordinances governing this fype olwork will be complefed L.. <br /> �vhether specified herein or noL The granfi.og o(a pemut does nof presume fo givo aufhority lo <br /> violafe or cancel the provisions of�ny olher sfate or local law regu/afing construchon or the <br /> pe�lormance oI construclion. That 1 am aufhonzed.by the owner o/Ihis property fo peAorm Ihe <br /> work Ior which application is made and 1 compty wdh fhe Sfafe Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> j (;'.;, �i'� i �:! / `1- �'�'�� <br /> .. $igrteNro� Dale <br /> Ii <br /> \ +-� <br /> l' v J �/�j� <br />