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ELECTRICAL PERMIT APPLI(�ATION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org 5 - a s-O 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �U7�S�� S3 <br /> PROJECTADDRESS <br /> ��� �+h,�l� �(�t�iF �:S � S l�,aw�s Si— C-.,t��� ��iw� z�r�54c� �S'w <br /> I Owner A1ail Addross City Slate2ip Phone <br /> ITenant A1ail Address Cily State2ip Phone <br /> � — ,;�.�,r�=✓ <br /> EleClriCal Conlrac�or F.fail Address Cily State!Zip Phonc <br /> Slale License Number Contracl Price of Work <br /> Proposed Use of Buildin� Conlact Person (Plan Review) <br /> Description u(Work lo Bo Done: C�-✓`���" �hlY'✓t:it ���« ir���^- �C^1 .• C� , C.nr�cN' ,�t^,.�( <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO fEE <br /> BE IN RACEWAYS, MC OR AC CABI_E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i 1 hereby cerfi(y fhaf I have read and examined this application and kno�r the sarne fo be frue and , <br /> correct. All provisions o�la�as and ordinances govemmg tl�is type ol work�rill6e completad � � <br /> whether specified herein or noL The gr�nfing o/��pennd does nof resume fo give authonty to '(_ �,'y�U��` 1 � <br /> violate or cancel the rovisions ol any other stafe or local la�v reguPfing consWction orthe <br /> perfomiance of coo ruction. That 1 am authotized by fhe o�rner o/this properfy to pedorm Oie <br /> work for�vhich app ' ation is ntade and I compty�vith(he Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �s <br /> / % �� <br /> �� ��/� � / � �.9 .,%�- j-7�-✓ / <br /> �^�i L,. '-'' v ,. <br /> Si(I��atur� Date <br />