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ELECTRiCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERV!rES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATI�PJS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 5 L� � �ul� � C'��� 5 / <br /> PROJECT ADDRESS <br /> , � ' ' � / <br /> i�l�-�UL= SI,v;�S�� V ly�G'' � r« �f� �� ��<•r���r" `i:�'t� <br /> Owner Mail Address City StatelZip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> `J V ��v('7 I H� ����, �+�/�HL/rlJ /'A �VJ'/'P7' /S G.CB 353��06'f5 <br /> Eleclrical ConlraClor Mail Address City Slate2ip Phone <br /> .�c�u:�% y� 7 �3�✓ �c��n, r c� <br /> Slale License Number CoNroct Price of Work <br /> ��F � <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> i•, � G <br /> Description oi Work lo Be Done: ?l,'l � �iN r7 i'�" V�l�N�' <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 /> I he�eby certily that 1 have read and examined this applicafion and know fhe same to be true and <br /> conecL All provisions ollaws and ordinances governmg this type ol�vork will be complefed <br /> whether spec�fied herein or not The grantin�ol a pemuf does not resume fo give authonty to <br /> vio/ate or cancel fhe provisions o/any ofher stafe or local law reguPting construchon or the <br /> performance o/construction. That 1 am authorized by fhe owner o/lhis property to pedorm the <br /> �voik lor which applicafion is made and I�omply with fhe State Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> v ' <br /> �-�, , � -j Z-.Q:-Ct ^i,� �d� ������ �� � <br /> . ��naWre Date . <br /> t= �'7 t � -��{ (p I <br />