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ELECTRICAL PERMIT APPLICr4TION <br /> ClTY OF EVERE7T PERMIT SEFtVICES 6 _ �0_�3 <br /> 32G0 CEDAR STREET, EVERETT, �NA 98201 (, �3Oy_��7 <br /> 425-257-8810 - FAX 425-257-8857 —w�vw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 4M TO 4 P14 <br /> 1��� Fv�rr-t}-j]�Ct ' Y< . , fl2t-. <br /> PROJECT ADDRESS <br /> Owner <br /> Mail Address City StatelZip Phone <br /> ��-�l\1�����C( 11_1� �L1CT..7�Ei1Pre�F ��l �,ssv�'"� �'��{!' WA <br /> Mail Address City State/Zip Phone <br /> Tenant ;,f� <br /> �' i ��� n ,.,i r L i�°9,�,'Nv (�'7�-I 3y3 <br /> �1,2 )ic,n�C`��,) �� ?_ai9E'�'xKc-r�r�.,�P, l� <br /> Electrical Conl tor <br /> (dail Address City State2ip Phone <br /> IE�rw�I �-Cz��'� - <br /> Stale License Number Conlrect Price of Work <br /> � LOr�T ��l�c�-�- <br /> �.� ��1 nt^ `���7 � Contact Person (Plan Review) <br /> Proposed Usc of Building <br /> � i , �� 'ill � n� nc � "I l�Z"k �l `7 <�r��/SG'�`./ <br /> Description o(Work to Be Done: I � IG �� <br /> I NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEVVAYS, MC OR AC CABLE. ti <br /> 5 C� - �>�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> �I 1 hereby certily thal 1 have read and exarnined this applicalion and know the same to be true and t� (� (��C� <br /> correcL All provisions ollaws and ordinances governing Ihis type o�work wifl be complefed 1�I�"�� `� l� <br /> whether specd�ed herein or noL The granting o/a pernut does nof presume to give aufhonty to <br /> violate or cance!the provisions oI any other slate or local law regulahng consfrucUon or the <br /> per/ormance o/conslruchon. Thaf I am aufhorized by Ihe owner o/this property to perform the <br /> work or wl ' h applic tion is made and 1 comply with lhe Sfate Contractors Law 18.27 RCW and <br /> 296. 00 AC. � � <br /> �� �' � � �/,� /�3 <br /> �� i r i��' , <br /> i iature �� -� Dale <br /> `--- <br />