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ELE�TRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PER�ViIT SERVICES <br /> 3200 CEDAR STr2EET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /oi3-� �'✓e.�.�.eK �v� �ee"G <br /> PROJECT ADDRESS� <br /> ����( ��� f ��- � Lcc .. <br /> C��MIB� Mail Aad ss Cih,� Slate2ip Phone <br /> Sino,��a �ljs3 /0/2/ �w,i.u.� h/•o+. �� NJA• 982eS� ��oc) e/nt-oi�z <br /> Tenant Mail Atltlress Ciry StatelZip Phone <br /> Lo oJGs. �S/G,vs �.�c . 7�1� �. �o �/'�� S+ Tcomn. /1/A �yoF/ �.�s�7s 6699 � <br /> EledfiCel ContfaCtOf Mail Address Cily StatelZip Phone <br /> �o�uCos� 033J'I/� ��2..gsa <br /> Slate License Number Contrad Price of W rk <br /> P��� <br /> �..2� /�Si B G£+�,s �7T-6�S"/ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: __.��/id'CG ��d��yN� R� NC.J Si yrv <br /> �ic�sn�-, �u..,,._.� <br /> -� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � ,Q <br /> So. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby certi(y that 1 have read and examined this opplication and know the same to be true and <br /> correcL All provisions ollaws and ordinances goveminq Ihis type of work will be completed <br /> whe(her speci�ed herein or not The grar!ing o(a pennd does notp resume to give authonty to <br /> violate or cancel the provisions o(any ofher stafe or local law regulating constnichon or the <br /> perlormance o/consfruction. Thaf I am aufhorizeG by the owner o/this property to peAomt fhe <br /> work/or which applicahon is made and I compl y ith the State Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> �— ��� <br /> 9-i2-�� <br /> ignaWr Date � ; ' <br /> _ 7 �,��� � �`L� <br />