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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE3 <br /> 3200 CEDAR STREET, EVERETT, WA 99201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM a AM TO 4 PM <br /> �o �C7 � I V-�V' � 6�-� <br /> PROJECT ADDRESS <br /> ��.�� ��_ <br /> � I`act' �r`e �� ��[� �ld�r� �Em �U�.ve� L�/�i�1�d1 �`�a <br /> Ownef Mall Addreae Clty State/7Jp Phana <br /> --X��'/'� <br /> Tenant Mall AdCreas Clty Stale/Zip � phone <br /> �r /; c�z� 2�7'— <br /> "1 6r�G� �I�'�.�V •'c. ��3vYsR5�A/`c r l�w� �/4- 9�'�1� S'3f(p <br /> EleCtrical Conlractor Mail Addmss Cily T Slate,Zip Phone <br /> �N ��u�z �� s-� �t'� ��� a�c�c � <br /> State L cense Numbor C ntract Price ol Work <br /> Proposod Uso o(Bullding Cordact Person (Plan Revlow) <br /> '/ ,�` `' � �� � <br /> Deacription ol Work to Ba Dono: «/U /� 5C� {�C�/ �y�G'(ii�� � <br /> 9cr u u �; �_- <br /> �� <br /> NOTE: WIRIMG IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I horeby certily Ihe(I l�avo read and exeminod fhis epplicefion and know the same to be frue a�id <br /> corrocL All provisions o/laws and orAinonces govam�ng fhls type o(work w711 be completed <br /> whofher sp�cifiod herein or not The granting ol a pe�mit doos notp resume to gfve eufhonty to <br /> violefo or cancel fho provisions ol any ofher state or local law regulefing consfrucflon or fhe <br /> perlom�ance ol construction. Thaf 1 am authonze0 by fho owner o!fhis property to pedorm fhe <br /> work lor wfrich epplicafion Is maAo and I comply wilh the Sfafe Contracfors Law 18.27 RCW end <br /> 296.200 WAC. <br /> i �� <br /> � <br /> ��,1�� � �-'��1�1--�" 1L� -- �(o - U �� <br /> i7� B��^ 1 Date <br /> �O� �G�O�i f� <br />