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� � - . <br /> ELECTRICAL PERMIT APPLlCATION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.crg <br /> APPLICATIONS ARE ACCEPTED FROM 8 A1N TO 4 PM <br /> � � 6 .� 1..�i �, ��- ,,.�A y <br /> PROJECT ADDRESS <br /> / <br /> ��t�. l.^ .L`H �►'`4+^�.3 �.j <br /> Owner Mall Addrses Gty Slale/Zip Phone <br /> Tenanl Malt Addresa Clty Stele2lp Phone <br /> N6 r T�e YH � � t h � .�/Y e �Y+ L �n G,. . <br /> Electrical Contractor ��Mall Addrons Ciry ' Stele/Zlp Phone <br /> State Lfcense Number Contrect Price uf Wortc <br /> Proposed Use of Bullding Conlect Petson (Plan Review) <br /> Descriptfon of Wor1c lo Be�one: Zs✓ /Y'Y �l�v `s� � � �� � �v M � <br /> VOTE: WIRINO IN NON-DWELLINaS IS REQUIRED TO �E <br /> DE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � � r"1 ,'y /_ �I c, <br /> ot ��`i <br /> 1 here6y ccrtffy fhet f hava reod and exemined thfs eppllcafion and know fhe seme to be frue and b <br /> correcf. AI!provfsions of/aws and orcllnances goveming fhls rype o1 work w!!1 be comp/eted <br /> whefhor specillad heraln or not. The B�ntlng of e permif does nof presume to pfve aufhorlfy fo <br /> violata or cencel the provlsfons o/any othar state orlocal lew regulet7ng construcflon orthe <br /> peAormance o/cons[ructlon. 7T�ef f em aufhodzed by the owner o/fhls propeRy fo peAorm the <br /> work Ior whlch appqcaflon!s mede end!comply wlth tho SYete Contrectors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> �.-L 1 �1f��.� L'� i y//.z <br /> Signalure Date <br /> t •d BLSB6S909E �1uQ�� aTZ �LO ZT i0 �d1i <br />