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`� _1r��05 <br /> ELECTRICAL PERMIT APPLiCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, V��A 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �' ��v �1ti� �3y �1 v� <br /> PROJECT ADDRES5 <br /> �,�1— <br /> ��vc,2�`� s y���/�� z 7�� � ,��� ��{ �'�zd� �r-l--���� <br /> OWnef MailAddress Gty SlateZp Phone <br /> (d� S 27(u G�v11� �'G �� �/J l�zGl 25'� �3Pz <br /> Tenant Matl aresa City Slate2ip Phone <br /> /v C���C � Q�n, u�a T3/�iC�/S�� /1�1�i�� 1 f�v r,��� ti �r 7J� �1zr=�Y7-7c <br /> [ledrical Contraclor Mall Add2ss Cily Slate2lp Phone <br /> ��E,�-�-e� � �s'� JG " /3 s-z "" <br /> Stala Licensa Numbet Contract Prico ot Work <br /> '� ,. �,,��iti�y ,J r� ��J�z/J t <br /> ProposC�d U of Buii ng Contact Person (Plan Reviow) <br /> Dr.scriplion oi Work to Bo Done: I� S � `l vOt G�'t Q` /��� �h L�r.� �� ��:.y/u�9S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 9E IN RACEWAYS, MC OR AC CABLE. <br /> CiTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily(haf!havo read and examined this apl��icalion and kno�v;he same fo be We and <br /> co�recl. All provisiuns ollaws and urdinances,qoveming Ihis fype ol work will be comple(ed <br /> whefher specibed herein or noL The granting o/a pernut does not p�esume to give authonty fo <br /> violafe or cancel the provisions ol any other sfate or local law regulafing consfrur,!ion nr tha <br /> perfomianco f conslruclion. That 1 am authunzed by Ihe owner ol fhis property fo peAorm fho <br /> �vork for whlc application is made and 1 comply wifh fhe Sfate Confracfors Law 18.27 RCW and <br /> zy�zoo W9 . <br /> ��vz�'-_-__ ff - /�- � S� <br /> � S nature Dale <br /> � [-1.51.3 � 11l/ <br />