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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everelAOVD.R�g <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � L—U�—U� <br /> �>Q�IZ-04 rj <br /> �I� ZO �Uf,UG�YP�IrI UJQ�I/� <br /> PROJECT ADDRESS <br /> �7�,�I�s I ne.• U3� UJ • C a.4v�e lb��k- 12�{• Gt�yldu.l�, AZ 5536 ( <br /> Owner Mail Address City State/xip Phone <br /> �o11aY Tree, �k�20 E��tvqvec.� W�-t EUe.ve�Fl 1j,1fl `�$`1�� <br /> Tenant Mail Address Ci y Statelxip Phone <br /> CommcYccca� ��UY�n ���{ec�;on �o gox i2� ►�ov,n�-v�,� �no� , wA q�2��, <br /> Eledrical Coniractor Mail Address Ciry Statefvnp Phone <br /> �N(-�VD�S <br /> C.oM ��E �z��$,�0 � 5, =,2�• 5� Cs�� T�x� <br /> Stale License Number Contract r'�ice of Work <br /> �/VI� vCa-v�i-lit., C61ad �vvf� <br /> Proposed r se of Building Conlact Person (Plan ReviewF <br /> Description of Work to Be Done: �. `� `I�Y�� 1''L�'` �Y t�� I I � I VY�V�.II Il� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQr Ik�D TO FEE <br /> BE IN RACEWAv S, MC OR AC CABLF 1�1 �, oo � <br /> 1 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heieby certify that I have read and examined this application and knotv the same to be tnie and <br /> conact. All provisions ol laws and orclinances goveming this type ol work will be cornoleted <br /> whether speci(ied herein or not. The granting ol a pernut does not presume to givP airthoiity to <br /> �iolate or_ancel Ihe p�ovisions o/any otherstate orlocal law regulating constru:aon or fhe <br /> perfomiance ol construchon. That I am atrt0onzed by the ownerolfliis pioperty lo pedomi the <br /> work(or whid�applicafion is made and I corr�ply with the Slafe Contractors Laiv 18.27 RCW and � <br /> 296.200 WAC. ' / <br /> l'Z/ 3�b�� � I �. - `t � <br /> Signature Date <br />