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� <br /> �LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT QERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM R AM TO 4 PM <br /> �I Lf Gt� i!�H�S E.-I.N,r�F}' I.SV� � �-[i5 <br /> PROJECT ADDRESS <br /> '�v�'�S ���:ce 273i1 /79;Iti, �vc' S�E' S��� lol 111crca/.�s�yw�_ �,)ag5�'(O �Lc� )231-' 19,�,0 <br /> O�vner Mail Address Ciry Slale/Zip Phone <br /> L��„� hl�Qe� �� t�+'G R.�,����, 1��� S 4�.l�le �,.. %�(��ti (.>,�i) l66—/s�� <br /> Tenanl Mail Address Ci�y Stale/Zip Phone <br /> �Jtqn� ! � /� // <br /> EIC �irical CoNraclor Mail Address Cily StatelZip Phone <br /> �./ //� � <br /> Slate License Number Contract Price o(Work <br /> Con lti�n��lr� �-jv�'P� <br /> Proposed Use of Building Contact Person (Plan Review) <br />` DescriptionofWorkloBeDone: Cle��{Yico.� ��)�Nnn cvi ��)��K ��vi �,^�tiY- <br /> NOT�: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerfily(hat I have read and examined fhis application and kno�v fhe same fo be true and �G�(y-1'Crp3 <br /> correct. All provisions ollaws and ordinances goveming fhis type ol work will be comp/eted <br /> whether specified herein or noL The granting o/a permd does nof resume to give au(honty to <br /> violate or cancel the provisions oI any ofher state or local law reguPting consfruchon or the <br /> peAonnance o/construction. That 1 am authorized by fhe owner o/fhis propeRy to perform the <br /> work for which application is made and 1 comply with the Sfate Contractors Law 70.27 RCW and <br /> 29G.200 WAC. <br /> .-- <br /> � � /�Z-.,- � ` � - � �� � `� �� <br /> Signa -r--tf c -�-- Dat <br />