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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S `.z _o ) <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �070 S-{Jls <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ../�'���- C�.��- .� <br /> PROJECT ADDRESS <br /> f�v v � �� 0 � e.Y I S S Ci Y�'1 C_ �_✓� ��- � Y��ZO/ ya3� �'�.�6� <br /> (hvnor Mail Addross City State/Zip Phona <br /> TB�BnI Mail Address Cip- Slato/ZID Phone <br /> / / � �Y1'1 � �li-' i7G ✓ <br /> Eleclrical Contrecto� Mall Address Cily Stale2lp phone <br /> State Liconso Numbcr Contracl Price ol Work <br /> /� <br /> Ll'Ci Y 0. ,9' �. <br /> Proposed Use of Buildinp ' Conlacl Person (Plan Revlew) <br /> Oescriplion ol Work to Oo Dono: V� ie1..c.�l-L�[c�_� �� <br /> NOT[: WIRING IN NON-DW[L.LINGS IS REQUIRED TO FEE <br /> E�E IN RACEWAYS, MC OR AC CA�LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereAy cnrtily fhnt 1 hnvo renAend exantined this nppl�cefion end know pio seme fo be frue and <br /> coirecf. All provisions allaws end orAinances goveming this type ol woric will be complefed <br /> whefher speaGed herein or nof. The granting o!e perrnif does nofp resume fo give authonty fo <br /> violafc or c, icel the provisions ol eny othor sfnlo or locel law regulefing construcfion or fhe <br /> pedomrance ol conslruction. Thef f em aufhonzed by fhe owner o�th�s property fo perfomi fhe <br /> wo�ic lor which applic»fion is rnade anA I compty wifh fhe Sfafe Contraclors Law 18.27 RLW and <br /> 29G.200 WAC. � <br /> / <br /> ;' r ( <br /> � • <br /> �����_� �_ `��c ��c —�/ _ �s— .� CJ �J � - � � <br /> SIE�nawie Da e ' <br />