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E���TRICAL PERMIT AF'PLICATION <br />CITY OF EVERETT PERMIT SER�ICES <br />3200 CEDAR STRC�T, EVERETT, WA 987_01 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS AR.E NOT ACCEPTED <br />9l� y�-' rc U C.rv,�cc.v Gv�.� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip <br />Phone <br />_% GS G VG C� 5�/'c SSn Sk�,.� ,�FS .r}-S�i�c. y�s'- 736— OSs7 <br />Tenant r Mail Atldress Ciry State/Zip Phone <br />_ Y 2�- <br />l�Eir <br />Electrical C <br />A1ail Address <br />hr Yr.i�� , �.S-L 3 <br />State Lfc�ense t umber <br />c���.� 5-la�n <br />Proposed Use of Building <br />City <br />zo3 7�6-gsss— <br />State/Zip Phone <br />� 3o v, �" <br />Conlract Price of Work <br />S~�� v�- P L o:� L, <br />Contact Person (Plan Review) <br />Descriptiono.`V�'arktoBeDone: �.uS�Aet i/) h,a��L� � GcD .bc�.-4�-r <br />NOl"E: WIRING IPJ �JON-DWELLINGS IS REQUIRED Tn <br />6E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF FVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ce.ii/y that 1 have read and examined this application and know the same to be true and <br />correct. All p�ovisions of/aivs and ordinances r�vemmg th�s type o(work �viU 6e comp/eted <br />whether speci6ed herein or noL The g�an[ing ol a permd does net presume to give authority to <br />violate or cance/ lhe provisions of any other state orlocallaw regulating construchon or;he <br />performance o! constructron. That 1 am authorized by the owner of this property to penorm the <br />werk for which application is made and I comply wi!h the State Contractors Law ; 827 RCW ana <br />�96.200 WAC. �J <br />_��� <br />� <br />/��/--� 7'/5-as' <br />iu Oate <br />FEE <br />� D5c7-D�i <br />