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ELECTRICA� PERMIT APF'LICATION <br /> CITY OF EVEF2ETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - JEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �ol f� <br /> _l l�' i�1 l°j���-v� , � � �}--�'o <br /> PROJECT ADDRESS <br /> (1�:r�rn��,: i��.�, Pd�v� � os� s�ui� ��sti C� %�9� �"�335'SZ�/� <br /> Owner Mail Address 1,�,, Slate/Zip Phone <br /> Tenenl Niail Address City Slale/Zip Phone <br /> h` �� S�'.pwc�� �.��=� /432�� �/�ccv u� S�t.tHo-niS� G�G} ,`?'��L�td 7�6•3G�jo1a1 <br />� Eleclrical Conlraclor .^.S;li AJdcess Ciry State/Zip Phone <br /> (� �LS-fzfz � f2SLN 57v� � <br /> Slale License Number Conlract Price of Work <br /> (� c�'7� I l� �G�'L 'J �c-����f�J <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Gone: W� rL-r�- S �f��/'L F � �L �,1 �G' �- %S _ <br /> � c��u� s � r�r�� c 5 ic:� c �� � � �t � s� <br /> NOTE: WiRING IN NON-DWELLINGS IS REQUIRED TO FEE , <br /> BE IN RACEWAYS, MC OR AC CABLE. ' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/y fhaf i have read and examined fhis application and know the same to be tn�e and <br /> correcf. A/l provisions of laws and ordinances yoveminc�(his type of work will6e completed <br /> whefher specified herein or noL The pranfing o/a pernut do�s not resume to give aulhonty to <br /> violate or cancel the provisions of any ofher slate or local law�eguPting construction or fhe <br /> perlonnance ol cons'ruc6on. That 1 am aufhorized by the owner ol Ihis property to perlorm the <br /> �vork for which application is made�nd I comply wifh flie State Contractors Law 18.27 RCW and <br /> 2 620 WAC. <br /> /��l � � � "1 �� <br /> I Signalure I Date <br /> i <br /> � � 'J <br /> .� � `, / L� J <br />