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ELECTRICAL PERNfIT APPLiCATIOy <br /> CITY OF EVERET7 PERMIT SERVICES <br /> 3[00 CEDR,R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - �AX 425-257-8657—vrww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM f ` � ,, � / <br /> {o <br /> ��� ( 1��.��Q�tS �1�V �} l�.Ak�i IA ��).A� � T���C/�n ��.1:� �I�tS�Ub � <br /> PROJECT ADDRESS <br /> ��L � ��IO.�c'i� �./ !�'1G�9Lttl' fLt�"I � .-1�1� ��i'v��.�lc� ����c�l�(y�f� �I�� � � <br /> Ovmer —� Mail tltlress Ciry State2ip yj$E�"C��7 7,7 <br /> ���1=N-��1�� l�'h�cer��!- 111�C l CUJ��__;:_,�'�'D�f 11�F1- 9 a ZOS <br /> Tenanl MailAddress Ciry g(ale2ip Phone <br /> {�F(�iec`S1V1C,llX�ll� 1����:�\�'c�r�YocnZY �C . .;.!:�,A.K�I_tt.�> (,Or� �£�75� �l�s �'US rzc/ <br /> EledricalContractnr MatlAdtlreS Ciry State2ip Phone <br /> �c��TL��JLi� >�IL�O:� <br /> State License Number Contract Price oF Work <br /> �'eCilach��Ct ��ti��A 1 i��i ��L11 ��(�u1"lQ �UC�Q�l <br /> Proposed Use o ilding Contact Person (Plan Re ' w) <br /> Oescription of Work to Be Done: rL( A'1 �-� �l�jll� . ��n� � C�ti�-�A I t"C�X Il�l fL�'�('����'-i <br /> ��.L_�- �Ii�U v�1�,'t,u-le U'i���'—1 <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby ceAily thaf I have read ard examined this application and know the same to be We and <br /> correct. All provisions ol/aws and oidinanc�s govemmg th�s lype ot work will be comp/efed <br /> whethe�specified horoin or noC The granfing of a permd does nof�resume to give authonty to <br /> violate or cancel the provisions ol any ofher sla(e or local law reyu/ating construcfion or the <br /> peAormance o!construction. That I am authonzed by fhe owner ol fhis proparfy fo perform the <br /> work for which applicafion is made and I compty wifh fhe State Confrac(ors Law 18.27 RCW and <br /> 296200 WqC. <br /> ,� ���������������L--� ���2���� / �'. <br /> ,\ SignaNre� ' Date ' I � � � <br /> � :� �- <br /> �-- (�� , <br />