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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ID �'3--0 7 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org C � 7�d -0O� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � -� ;� t�t J��-1'������, ��� (i�s��s�l - <br /> PROJECT ADDRESS <br /> �-l(.,�10 <br /> �/ � 1�c:c_��� c�. Z�,v��s�r..e��s ��.�LLC. `ve�e,�-� ,�.�t`�`�C�\ <br /> � ner 1.1ai1 Atldress City State/Zip Phone <br /> TenaN M11ail Address City Slale/Zip Phone <br /> Eledrical Conlraclor A1ail Addres.; Cily State/Zip Phone <br /> � / � ��� 0 <br /> Slale License Number 'Conlracl Pr`ice o�f Wlo`rk <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> 4 <br /> Descriplion of Work lo Be Done: , ��'l��� I � .�— <br /> NOTE: W IRING IN NON-DVJELLINGS IS REQUIRED TO FEE n <br /> BE IN RACEWAYS, MC OR AC CABLE. /j��„�jC,' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I l�ereby certi(y that I ha��e read and examined tliis application and kno�v the sarne lo be hue and <br /> coneG. All pio�-isi ms ol la�vs and ordinanr.es governmg fhis fype of wo�k will be complefed <br /> whether specified hercin or nof. The g�.�nlin�ol a pernuf does nof p�esume to give aufhonfy to � � .����� <br /> violafe or cancel lhe provisions ol�ny ofher state er local lau�regulafing cansfruchon or fhe /��L� <br /> periorrnance ol construc6on That 1 am aufho�ized b}�fhe otvoer o/Ih�s property fo pe�fonn the �. <br /> work lor which applicafion is n�ade and I conq;ty u-ifh Ihe Skife Contracfors Law 78.27 RCIN and �`�� ��- � <br /> 296.200 WAC. <br /> l` <br /> �� <br /> � <br /> ___/� , �- __-�,�, _ -�.L �0 I \ l�C`o'� '- j/L� -C�C?�� <br /> / signawre oate L- <br />