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S -3 � -o� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET. EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-?.�7-8857 — v,nvw.everettwa.org <br /> APPLICATIONS ARE ACC.EPTED FROM 8 AM TO 4 PM <br /> ;�'7"Z2 Cb i b y ,�„� Fver�� <br /> PROJECT ADDRESS <br /> � � �--� 1 � -f-� (.J 42S ZS 2'1 ZL . <br /> �G i,�i�� �� � �o:� U �'C ���rL � <br /> Owner Mail Addres City Stale2ip Phone <br /> Tonant- � MailAddress Ciry Stale2ip Phone <br /> � <br /> ,Mt;���- c�M�,�,•«a���.l,� C�,Lc���.��. sE Suv�,�„S�� �� r,y2�iU yzr�o�i�a� <br /> Electrical Conlraclor Mail Address Ciry SlaterZip Phone <br /> MC�t'ZK«9�S�;Z <br /> State License Number CoMract Pnce of Work <br /> �_��L �ja<L' I�-��� /CSC.fov�/ �' �n SkvrS�/' <br /> Proposed Use f Buiiding Contad Person (Plan Review) <br /> Description of Work lo Bo Done: V���CI��ti �4��I'"`t <br /> NOT[: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf f have read and exarnined U�is applicafion and know fhe sarne fo 6e true and <br /> con�cf. All provisions ol laws and ordinances govemine�fhrs type ol work�vill 6e completeA <br /> whefher spec�6ed herein or not The g�anfing o/a pernut does not presume fo give aufhonry fo <br /> violate or cancel fhe provisions ol any oUier state orlocal la�v mgulating constniction orthe <br /> pedomiance o�construction. T7iat 1 am aufhorized by the owner ol this propeRy to pedonn the <br /> work lor which applicafion is made and 1 comply with fhe State Contracrors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> � I <br /> i <br /> ,�i,� s�3�1� � <br /> igna ure Date <br /> ��bs -`� /� <br />