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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 6_�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 �-J <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org ���a3`Ds� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �i (� �V¢v�rveo..� ��� �Vcninl� Sv;�� #S <br /> PROJECT ADDRESS <br /> �Gr�Se pro `�� M <br /> �Zn- � �'n;t. '1 ' ,�"�v,��4ny.� <br /> Owner MaIlAddress City SWte21p Phone <br /> Co� �f�„ C�:,,�c, �d10 �'vnauNc�v, �J�� �unno�' (.�e <br /> Tenant Mail Address Cily State/Zip Phone <br /> 1J�k�.l. � i<,��;� i �aa a�y'" s> 5� �3or�ll �k 5�� � �125-4�8-741$ <br /> ElectricalContraclor MailAddress City State2lp Phone <br /> DU�cI� � �'�R/o�J � l �cc� <br /> Stale Lir,ense Number Contract Price of Work <br /> �t+�woJ�J rnB.;,r �or� l�o� <br /> Proposed se oi Buildi � Con;"t Person (Plan Review) <br /> Description of Work to Be Dono: ��n5�G� � ��- rw�n — De..,oh ���c✓` � ��P�G�t ,3'Ginc uJ-}S <br /> �Fc,k �.Jc-va w;+�ao1 in �ar�,�yc <br /> N'�TE: VVIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I-� <br /> I hereby certify fhat I have read and examined fhis application and know the same to be frue snd �I I v��� <br /> correct. All provlsfons ollaws and ordinances goveming this type oI work will be completed <br /> whether speci�ed herein or noL T.he r�ranting of�pemut does nof resume to give authonty to <br /> violate or cance/the provisions of any other stafo orlocal la�v reguPaBng construction or the <br /> pedormanco o(construcfion. Thaf I am aulhonzed by the owner of t hfs property fo pedomi the <br /> work/or which application is made and 1 comply with the State ConLac(ors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> � � C�4- � l��/2�,� <br /> Sic�nalure D�le <br />