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ELECTRIC�►L PERMIT APPLICATION <br /> CI�fY OF EVERETT PERMIT SERVICES , <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ! <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i � i � � E✓c-� �2 "c� �J� <br /> PROJECT ADDRESS c_ <br /> �vc�rz 2a �v�-�' " 2 a�, t1�� <br /> Owner � Mail Addres City State2ip Phone <br /> r <br /> ��� � � �� <br /> Tenant Mail Address City Stata2ip Fhone <br /> �rtr��r r�,l� �� c� �r� �f�� �T Lp+� i�aan � r i,Ja GNt�N � <br /> ElectricalContractor MailAddress Ciry StatelZip ��S G 3�ha�4.a�b <br /> _� <br /> ,�iR �.M r � S��-/ � 2 � y s� o ° ° . <br /> State License Number Contract Price of Work <br /> � �L 2 � <br /> �SI ✓a lA 2c�� l <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Descriplion of Work to Be Done: A �n ��-r�o .� ��n--��C�Z4 SS 1 Ovv �"o �"� R � ����'1 <br /> S�v f C �.n C�,r c� �4-1>> c`� .���� ) �`2 ei��S <br /> 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 /> 1 hereby ce�tily that I have read and examined this application and know the same to be true and <br /> co�ect. All pravisions ollaws and ordinances goveming this type o!work will 6e crompleted <br /> whefherspecifred herein ornot. The granting o/a pemut does not presume to give authority to <br /> violate or cancel the provisions o/any other state or local law�egulafing construction or fhe <br /> peAormance o/construction. Tliaf 1 am authorized by the ownerol this propr.rty to per/orm the <br /> work for which applicahon is made and 1 compl}•with the State Contracfors Law 18.27 RCW and � <br /> 296.200� <br /> � � /_�n � ��1�2 � <br /> Signature � Date <br />