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EL.ECTRICAL PERMIT APPLICATION <br /> CITY GF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, �VA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - www.everettwa.org (� ��� �o� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C,�FJOC7"0l�3 <br /> � �b� - v[7Ual./ � - <br /> PROJECT ADDRESS <br /> SLi.�.t,�,r �a� � � �-�--�. -- <br /> Owner Mai�AdOress City State!Zip Phone <br /> -- <br /> Tenant MailAddmss City SWte/Zip Phone <br /> �Z�� I <br /> IQKA Ec�C. �-Db3 ��'" 1.��• S�' � Stiol�ur-��s� Wq, Q$Z.�'p z•}�Z3i'- <br /> Eledrical Conlraclor Mail Address City SWte �p Phnne <br /> l�K(�EL.E'��C�SNr� gSoa �G � <br /> State License Number Contracl Price of Work <br /> S • F �2 <br /> Proposed Use oi Building Contact Person (Plan Review) <br /> Description of Work to 8o Done: iCM���PJ1. / �1•�-�1ti� d 1� <br /> �'1.8'L�.�¢- Y4 , � l��542 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC�WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily ihaf!heve read and exarnined this applicafion and know fhe same to be tn�e and <br /> coimct. All provisions ollaws and ordinances goveming this fype ol work will be complefed � �,t �,�L . ,,�, .� <br /> �vhefher specilied herein or noL The granting o/a permd does nof nesume to yive aufhority fo - - <br /> wolafe or cancel the provisions oI any other sfate or local law regu/ating consfrucfion or the <br /> perlormance ol constn�ction. That I am au0ionzed by the owner oI this property to perfonn the <br /> �rcrk for�vhich abpli de and!co � dh flre Stafe Confractors Law f 9.27 RCW and <br /> 29G.200 Wf 1 <br /> � ,.� 6�z4 ��� <br /> , <br /> Signalu e Dale ��, <br />►' — - - ..___ _..- -- -- ------ <br />