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ELECTRICAL p�RM'T APPLICATION <br />CITY UF EVERETT PERMIT SERVICES <br />3200 CEDAR STREtT, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-E3857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />(032� t��E�GR�F�\ t,lfly <br />PROJECTADDRESS <br />�"' - �' -� j <br />� o�o �'--�I q <br />1�1v i � fi1R�(ZM�t� K,�3_Z�S ��REi�:, i IJR� �v�f�E1T ���1; q�,, ���53 - y <br />Owner Mail Address City State2ip phone <br />,�fh'�.t.E <br />Tenant Mail Address City StatelZip pi��ne <br />S't'�gE�t til� SI -C� � <br />�A�A�fV1hlC-� I�D�L� a n A f1Y� ( 1 �}i"(��iFl In1� �� 1`3 � 61e� �-12 f'�'f3� <br />EIeCIncalContr ^.tor MailAddress Cily Stale2ip Phone <br />f,�lO�ZE.�`A�l�il�'t�1 <br />State License Number — <br />Proposed Use af Buiiding <br />Description of Work to Be Done: <br />Contrad Price of Work <br />M���I('-i IA2b C' <br />Contact Person (Plan Review) <br />NOTE: VI�IRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OP, AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I hava read and examined this application and know Ihe same to be lrue and <br />correct. All provisions of laws and ordinances governing this type oFwork will be completed <br />whether specified herein or noL The granting of a permd does not presume to give authonty to <br />violate or cancet the provisions of any oiher slate or local law regulating construchon or the <br />performance of construction. That I am aulhorized by Ihe owner of this property to perform the <br />work for which application is made and I wmply with the State Coniractors Law 18.27 RCW and <br />296200 WAC. <br />FEE <br />�,�n_ �"1 <br />