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---� — -- - <br /> �LECTRIC.�►L PERMIT �►PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �_ao-c�q <br /> 3200 C;EDAR STREET, EVEREl i, WA 98201 <br /> 425-257-8810 - FAX 425-25'i-8f157—www.everettwa.org �'���y`� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,�-�� <br /> �1.��� ._�i10���?. `�,L�(�'�,� G �T �1�GL7� ��`�-y y�QJ"�� �� <br /> PROJECTADDRESS � ��?/ <br /> /�a F�t�i��D�.c�/10� <br /> Owner � Mail Address � Cily Stale2ip Phcne <br /> �1�('. ��l�j, �,��5 �d .�✓�r�e„ �,���� � �le�� c✓c, . 9 °z� 3 <br /> Tenant Mail Addr s � Cily Slale/Zip Phone <br /> /��ST �1.��;�<< �� � �, o�� ����-���� s,�, ��,��f„� �..� ���� � <br /> Electrical Contractor Mail Address Cily StatelZip Phone <br /> f��'7'�c,k r�-rn�-1�� � I sa�.� <br /> State License IJumber Contracl Price of Work <br /> c <br /> ���/D�qJ D �c..-c,�. <br /> ProposedUse of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �IJ S��l�� (���LC�� / /�cY� �t�h�S • <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY O! EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf I have read and examined fhis applicatiun and know the same to be frue and <br /> correct. All provisior.s of laws and ordinances governing(h�s type o/work will be completed <br /> whefl�er speafied herein or noL The granfing ol a pernut does not resurne to give authonty to <br /> vio/ate or cancel the provisions o(any other st�te orlocallew reguPting consWction or the <br /> peAormance o/const�ucfion. That 1 am authorized by Ihe owner o(this property to perforsi the <br /> work lor which applicalion is made ar,d 1 comply with the State Contractors Law 1827 RCW and <br /> 296.200 WAC. <br /> '` ,-?-O � 4 <br /> �>,� ,�---� � � �� <br /> SignaWre ' Date " n <br /> �}1U1 <br /> � � I <br />