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i <br /> ELECTRICAL P�RMIT APPLIGATION <br /> CITY OF EVERET'T PEFc1AIT SERVICES �/- 3,3/D <br /> 32U0 CEDAR STREET, EVERETT, WA 98201 ��D �� —� 2 3 <br /> 425-257-8810 - FAX 42.5-257-8857—www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �-Sa�- ��Ib�, I�� <br /> PROJECT ADDRESS <br /> Owner Mail Address City State2lp Phono <br /> � <br /> �-�Cf��1 ��+���, l��r-t�T �'S-aE:����.� �t�,��Jp Q�2G� <br /> Tenanl Mail Address Gry Slate/Zip Phono <br /> I,�(`(t:li-h�H�2l�(z1��icu�� ��'l.�l(..Qi �W V—�'l'11� � r �!I►„��u.-� I�JA 9�� <br /> Gedrical Contreclor Mai!Addresa Clty S�ateZp '1�L�.,,Z��-� Pho�n,e <br /> • �Y�f <br /> I����t"N ��� q0�.�1-1 ��0��`�' <br /> Slato Licensa Number Conlracl Price of WorY, <br /> Proposed Use of�uilding Conlacl Person (Plan Roviow) <br /> Description oi Work to Bo bono: �{"���u�I �`� �� �I�v ������- C�LI�\-�1 <br /> NOTE: WIRING iN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> I herehy certi(y thaf 1 have read and exemined Ihis application nnd know Uio sar.io to be frue and <br /> con�ecL All provisions nf laws and u�dinances gorerning fhis(ypo oI work will bo wmpleted <br /> whefher spea6ed Oeicin or nat. The�ranfing ol a pem�it does not prasumo to givo authoritylo � <br /> violale or cancel the provisiens of any olher stale orlocal law regulafing construcfion or fhe <br /> perfomrance ol censtruction. That 1 am authoiized 6y Ihe owner ollhis properiy to periam Ihe '� <br /> �rork lor which applrcotion is ntade and 1 comply wifh the Sfate Conlractors Law 18.27 RCW and OI f � <br /> 29G.200 WAC. I J I <br /> / <br /> ������ " �C rz 2o�c� <br /> Sipnalure Da�e <br /> L_ <br />