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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVECES ,' <br /> 3200 CEDAR STREET, EVERElT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org 1 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �;?�,17 l'cc-P��AvC <br /> PROJECTADDRESS <br /> I <br /> i <br /> �t�� Tczl (',nn�Jl.i,V�Tz/ f� ill� a? b l7 Cp�r3y f;,/G A/E',pr- rT'. /�/+ _ <br /> Owner all AdOres6 City Stale/Lp Phone <br /> Sara�� ' <br /> Tenant MaIlMtlress Gry Staterzip Pnone <br /> Ini7�C�gL'Y NFrWaeKs 3702 l�� Ua�lcv Nwv ,u �.�i2 f�ut3ur_N Wr� <br /> ElecVicalContrador MBIIAGClCBB c�ty��� � S�C� �Qi1Ul Fno"e, i3 � <br /> /�/Tr Cati l 9�55� 9 � ` ���b�� <br /> State License Number Contrad Price oF Work <br /> �Xis•ri,� � d�r�K _ �'hri� _ <br /> Proposed Use oF 8uilding Contact Pereon (Plan Review) <br /> Description of Work ta Be Done: �DW /�LT/4 E� ��EL u� 11�/�f3�!N E� <br /> NOTE: VNRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ` <br /> j �J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certdy thaf 1 have read and examined Ihrs applicafion and know Ihe same to be fn�e and <br /> wrrecL All pruvisions o!laws and ordinances,qoveming th;s type of work wdl be completed <br /> whefher specified herein or noL The granting o/a permd dces not presume to give authonty tc <br /> wolate or cancel the provisions ol any othei state or local law regulafma constnichon or the <br /> performance o/consPrucLon. That 1 am aufhonzed 6y the owner ol thisp roperty�o peNorm the <br /> work/or whrch application is made end 1 comply wdh the Sfate Confractors Law 1 B.27 RCW and <br /> 296200 WAC. <br /> � �, <br /> � ` �-� � � <br /> �,.� ., - - <br /> Si iaWre <br /> Uate � � <br /> / <br />