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E.'LECT'R�C�,�1L PERMIT APPLICATION <br /> CITY OF E''JERLTT PERMIT SERVICES <br /> 3200 CEC!AR STREET, EVERETT, WA 98201 <br /> 425-'257-8810 - FAX 425-257-8857 - www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��113 F��=To� <br /> PROJECT ADDRESS <br /> � �� �L�� <br /> Owner Mail Address . City Stale/Zip Phone <br /> Tenanl MailAddress Ciry Slate2ip Phone <br /> 4�1`�lfn 11" C(,CC���1C, INC, ��os 2.�Is1" s T N�,.1 �-r(�NI,�l� �J�� q�2`i2 <br /> Electrical Conlractor Mail Address C�ty SletelZip Phone � <br /> y25 ;o�5�5r1 'i <br /> Sr i M T� I Cti nvo I<? _ SS G� <br /> Stale License Number Contract Price of Work <br /> � <br /> ���12. <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> �7 5(71 <br /> Square Foolage (If residen�ial new construction,remodei or addition) <br />, <br /> Description of Work lo De Done: � C�JU ��Q UUe���c�� 5C �`� i�-c �`J I F�' NEw <br /> aY � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO � FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �D _Q�71 <br /> ,� V <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � 1 he�eby certity that I l�ave read and exarnined this applica(ion and kno�i the same(o be fn�e and � r <br /> � correcL All prowsions ollaws and ordinances govemmg fhis type ol�•�o�k will be completed L I �/� n�j`j <br /> �vhetherspecified hei�in ornoL The granfin9 oI a pennd does ncf pres�n,e to give authonty fo � V � <br /> violate or cEncel the prov�sions of any olher'state or local la�v regulatmg construction or the <br /> pedonnance of consfn�ctron. That 1 am authonzed by(he ownerol this pinpe�ty to pedonn the <br /> woik lor which applicatwn is mode and I compty�vith fhe State Contraclors Lnw 18.27 RCW cnd <br /> 296.200 WAC. <br /> � ` �,.�_ f I� 13 . <br /> Signaturo D..e <br />