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�b -ig-o6 <br /> ELECTRICAL PERMIT APPLIC.�►TIC1N <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPL�CATIONS ARE ACCEPTED FR0�7 8 AM TO 4 PM <br /> ,2��0 �0 6� <br /> PROJECT ADDRESS <br /> / `/'� r � 9 CG"1�C/ <br /> Owne� Mail Address Cily Stale/Zip Phone <br /> l � <br /> � � <br /> Tenant Mail Address Clly State/Zip Phone�9 <br /> 2cfv—J"j— <br /> l� I/r�� �1��¢rr<</ �GC /?�:/GG� ��/ �-�. y�oGy_ ��G� <br /> EleclricalContraclor..-� MaitAddress City Slale�Zin Phone <br /> �L�,�C� Y��U�' � �� %;�� z� o — _ <br /> Slato License Number ' Contracl Price o(Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work lo Ba Dono: �� �HJ� C r/r ( � �/e��it/fJ{� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R4CEWAYS,MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> !hemby certify thaf 1 have read and examined fhis ap/�licafion and kno�v fhe same to be frue end � <br /> conect. All provisions ollaws and ordinances govemmg ihis tyHe o!worlc will6e completed <br /> whefher speafied herein or noL The flranting o/a pennd does not presume to give aufhonty fo I <br /> violafe orcancel the �rovisions olany ofher s(a(o orlocal law reyu/nfinr�cons(ruction or(hc <br /> peNom�anco o/cons�n�ction. TAaf 1 arn authonzed by t0e mrner ol this property to perfonn the <br /> �vor/c lor wliich application is made and 1 comply�rifh fhe Sfafe Contractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> ��. /'/ <br /> �.Y����R��yw(//� �%�[� vC� � <br /> Signa�ure Dale <br /> � � ' �/ <br /> �� r <br /> I ' <br /> � ��_, - <br />