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ELE�CTRICAL PERMIT APPLICATI�N <br /> C17Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8fl10 - FAX 425-257-8857 —www.everettwa.org ,�-19 `�'8 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM E��03`G9� <br /> ,/ ? � ; �i� � '1 <br /> / ��V�re`� f u.;«. - �:.� �� �:�J <br /> PROJECTADDRESS �''�i��� ����"'�`—� <br /> �) I J - _ <br /> . <br /> �Cc.'J, dc.t[z /IC�S`�i(�.�- U�vP� L�/��-. `"fGC-L'� <br /> Owner Mail Address City StatelZip Fhone <br /> Tenanl Mail Address City State/Zip Phone <br /> �1 -� � `!2 J ' <br /> tl�0in� t ���'�r�� �J,L� 2c%> � �rc�ru ��t; tc�t�.> V-JG�. ��ZS Z 3Y6� 7:� � <br /> Elecirical ContraClor M11ail Address Ciry State2ip Phone <br /> l% <br /> ���L, ��7C.� CJUO � � � �t%C.�' <br /> State License Number Contract Price of Work <br /> L,�� a, �._ l. ��. — <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Descriptiono(Warklof3eDone: l✓! 5'�c�� (c�(�2�y1 0�� �CuJ lrU('(���-�� �✓i �d���C CUY1���C3 �S <br /> t � `�� 1��,\� `-� Y1.I�Y1'hD>'Ic.:l.� � <br /> NOTE: INIRIfJG IN NON-DWELI_INGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cc-�7ily that I have read and exarnined fhis applicalion and hnow the sarne to be frue and <br /> correcL All provisions of laws and ordinances governing this type ol�vork�vill be completed <br /> whetherspecilied herein ornot The granting o(a perrnd does nof resume to give aufhonty to <br /> violate or cancel fhe provisions ol any ofher stafe or local law reguPting consfruction or the <br /> performance o/construcfion. That 1 am autho�ized by fiie ou�ner ol this�roperty fo perform(he <br /> work lor which application is made and I comply�iifh fhe State Confraclors La�v i8.27 RCIh�and <br /> 296.200 WAC. , <br /> �t �.�,fi a , ' - �i�_ �-:,'.. <br /> ' Signalure Da1e � <br />