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ELE� 1'RICAL PERMIT APPLICATIOfV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25?-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - OEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />T-r� N.�� C_{-��1Pf1 LA <br />9629 _F_ vcr�jr��.� wA�� ��;-�F. ad3 <br />PRO.:ECT ADDRESS <br />`�'� r'i' ' � '�- �3� <br />�-�2 % 6�Z 7 L l�rsZC��-.::,�:.�,r�c� �ve9-e.-t-� c�J,4 . 4-�S-35S-�3_ <br />Owner Mail Address —r City State/Zip Phone <br />��/�' n'1 � <br />Tenanl Mail Address City State/Zip Phone <br />��.C..�lo�-Tfr; ���, �.'�, �jc7)C T�G �he�olm�S� ( �1Q• %�S'.�c-� `�?7-34�-9 <br />Electrical Contreclo� Maii nddress Ciry Stale/Zip Phone <br />� � z �=�� 99 6 I%� I I� ! � g oo, Q� <br />Siate License Number ��' / Conlract Price of �Vork <br />��o�}N �� C�,�:,-,�� <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work ta Be Done: T r� S't�il l�i�' i� r. Cl� �-� to 6n � ti(p SC��� N�= / <br />Qv�c� �—� C> > Y G�.�> �� lr S l�n a� � � i C i� e v� Q�' �, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />i hereby ceRify that I have read and examined Ihis application and know the same to 6e true ar <br />correct All provisions o/(aws and ordinances goveming fh�s type o/ work �vi116e comp/eted <br />whether spec�fied herein or noL ihe gracting ol a pemut does not presume to give authcnty to <br />violafe or cancel the provisions o(any other stafe or /oca/ law regulating construction or the <br />pe�formance o( construchon. That 1 am authorized by the owner o/ th�s propeRy to peAorm the <br />work /or which applicafion is made and I comply with the State Contracrors Law 18.27 RCW an <br />296.200 WAC. <br />- 06 <br />�c <br />FEE � � <br />