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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ��.� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.org j " <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 101� 1 � E�P ����Pe� Ul�y S <br /> PROJECT ADDRESS <br /> �.-��.�,��. �-�o�d �. <br /> Owner Mail Address City StatelZip Phone <br /> Tena�t Mail Address City Slate2ip Phone <br /> � �� 5 E�e�� ��� P01?oXl�� Marysv. �l� �,•1R 982�0 .360-6�9�1�/ <br /> ElectriCal COntractor Mail Address J City Stale/Zip Phone <br /> �s FI,� � -� oza a Z �zl, 000. ov <br /> State License Number Contra�o(Work <br /> S�rv� cF �,oa��ffv,P�T �QN �i /�Osuv <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description o(Work lo Be Done: VV (✓e f V e� �V�I �1 y G� �� I� 'i i `7�S � �� V( C�� <br /> 60f� -�(�P c�P� -f�'�,,., e X�'sT,.��, ��,9�_ <br /> NOTE: VJIRING IN NON-DWELLINGS IS REQUIRED TU FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LQCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y fhaf 1 have read and examined fhis application and know the same fo be true and <br /> conect. All provisions of/aws and ordinances goveming fhis type ol wodc will be completed <br /> whether specified herein or noL The granting o/a pemut does nof presume to give authonty to <br /> violale or cancel tlie Provisions of any otlter stafe or local law regulefing consfruction or fhe <br /> perfonnance o(constnicfion. That 1 a u onzed by the owner of this property to pedorm the <br /> work for which applicafion is mad nd 1 com wifh the Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i <br /> � � 4���L � �3—�� x � <br /> SignaWre Dale / � .J <br /> / //I V <br /> l.J' <br />