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i <br /> ELECTRIGAL PERMIT APPLICATION <br /> CITY OF EYERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 "a �—�/ <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org [ ���3 y��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �ZI� �v���—.�., �v�+n����z� q�Zv3 <br /> PROJECTADDRESS V —� <br /> �� <br /> Wnef Mail Address Cily State2lp Phone <br /> 1(ak_.�IASfL1n �� <br /> Tenant Mail Address Cily Slale2ip Phone <br /> �'h�('., �[�r, `�.,a[ �i�i?�w �k'— S�- s �G�rGCa,,,w� u�va- a2��z, yZs'��u �o3a <br /> Eleclrical Conlraclor Mail Address Ciry SlalelZip Phone <br /> P�C��'P�'P � ,�01�✓�� �,ov"D <br /> Stale Licenso Number Confract Price of WorP. <br /> M��t o�� t)'� ( mnn�ue.Ga-� <br /> Proposed Uso of Duilding Conlacl Person (Plan Revietv) <br /> Descriplion of Work to Bo Dono: �� 1�V1�{Q� lG/(E�IU� �lM� �I'tC.-S 'yrs. <br /> �t,;�,� `.�7�5 �A <br /> I NOTE: WIRING 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 � <br /> I hereby ce�tify that I have read and expmined lhis ep��lica(ion and kno�v the sarne fo bo f�ue and ril 1 (��' l l � <br /> correct. All provisions of laws and ordinances governmg this typo o/�+orlc ivill be complofed <br /> whether specified hc�ein or noL The�ranfin�o/e ponnd does not resume to give authonty to <br /> viola(o or cancel the provisions of any oflier state or local law��guPling construction or fho <br /> perfomiance of constn�ction. That 1 am authonzed by the o�vner of this�roperfy fo peAomi fhe <br /> �vork lor which applicntion is mado and I comply tavfh tho Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �"� ��l.til/i <br /> �—Sic,�na -� Dat <br />