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( . <br /> EL�CTRICAL. f�EF:IVIfT APPLICATION <br /> CITY OF EVERETT i�ERMIT �ERVICES 6 _���� <br /> 3200 CEDAR STREET, EVERETT, VVA 98201 ZZ <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org E � �0 6 '� <br /> APPLICATIONS ARE ACCEPTED FROM S AM 70 4 PM <br /> �o�al-���.� td� - s�, ��a� <br /> PROJECT ADDRESS <br /> Owner Mail Address Gty State/Zlp Phone <br /> / � ,�� ��►-/� -' / . Z <br /> enant Mall Address CIty Stale/7Jp Phone <br /> �-8�i''� � LCI�./�.��7,�nC �1�� -��7'� l� 7?I►`� 32 3 <br /> Electrical Conlractor Mail Adayess Clty / , $ t�� h�o�e <br /> � �� <br /> �CTr-�'aS37�r1� � ��.�. ma <br /> State License Number Contract rice Work <br /> Proposed Use of BuilcJ g Contact Person (Plan Review) <br /> / <br /> Descriptlon of Wor to Be Done: ��"�% �� � ^ � � <br /> � " <br /> NOTE: WIRING IN NON-DV'ELLINGS IS REQI;IP,ED TO FEE <br /> BE IN RACEWAYS, ,NC OR AC CP.BLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily that!h ead and examined this application and know fhe same to be true and <br /> correct. All provisi of I ws and ordinances goveming this type of work will be completed <br /> whether specifie erein r not. Tlie granting o/a permit does not resume to g(ve authortfy to <br /> violate or canc the r isions of any ther state or local law reguPting consfrucflon or the <br /> peA nce (cons cfion. That I authorized by fhe owner o�this property to perform the � � <br /> w lor wh h ap ' at' n Is ade n I compl�with the State Confractors Law 18.27 R W and � I <br /> 7. .200W C. //O � <br /> � � ( <br /> re Date <br />