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ELECTRICAL PERMIT APPLICATi01� <br /> CITY OF EVERETT PERMIT SERVICFS <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ����� ����1.�%�� <br /> PROJECT ADQRESS <br /> �—L'I��s N-��,-r fil �s�r��-Z ���- S�? 3y 5 .�� <br /> Owner Mail Address City StaleRip Phone <br /> Tenanl Mail Address Cdy Slale/Zip Phone <br /> 1�2A s5 � � '��€��, P ., -33 S-��.,� <br /> � �.0� S'40 �7- 5-��co <br /> Eleclncal Conlractor Mail Address City State2ip Phone <br /> 1�2f1SS �, t� 1 �� �`) `� I��do�� <br /> ulate License Number --� -- <br /> Contracl Price of�Vork <br /> :���-�tc - C��.(�� <br /> Preposed Use of Buildmg Contact Person (Plan Revie•�v) <br /> Description of Work fo Be Done: h��j� ��� .{��p;'�. � P �--�A '— <br /> ��Pu�c..� �y_t s i n! -� tC�o Ar�,P �J�S� s w _w t�-.� <br /> �� k��-c -�� P A � G� CA2 Po�,.��R., F rr ca�c,v��- <br /> PJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, h7C OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf I h,�ve read and examined lhis application and know!he sarne to be frue and <br /> conect. AO provisions ollaws and ordinances govarnmg fh�s type ol�vork�rill be cornple(ed <br /> whefher spec�fied herein or noG The granfing ol a permd does not �resume!o give aufhonty fo <br /> violate or cancel the provisions ol any o(her sfate or local law regulafing conshucfion or the <br /> perfomiance o/conslrucfion. That I am aufhonzed by Ihe oivner ol this p�operty to pedorn�;he <br /> work Ior which applicafion is rnade and I comply with the State Contracturs Law 78.27 RCIN and <br /> 29G.200 WA <br /> Signature _. � v � . <br /> Uale <br /> i J � / �� <br />