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ELECTRICAL �ERMIT APPLICATlO�1 <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 5-/3 �/3 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org CJ3o 5-O� <br /> APPLICATIONS Af2E ACCEPTED FROM 8 AM TO 4 PM <br /> '� � � L�(;iv► ���r5� 1�'���' <br /> PROJECTAD RESS <br /> 6 r���no�u St�,v-e� <br /> OWnef �%� MailAddress Ciry SlatelZ'�p Phone <br /> Tenan� Mail Address Cily State/Zip Phone <br /> �-��� �.ly,..� LI��f��� Ll`f/v G�.�� ;� e ��.�,�� �'(�2c3 <br /> Eleclrical Contractor Mail Address Cily Slate/Zip � on,/ � <br /> �z5 --7 �•- <br /> LL� �� � ES� J� � � �L� � �, S� . �J <br /> Slate License Number Contracl Price of Work <br /> Proposcd Use of Building Conlacl Person (Pian Reviev�) <br /> Description of Work lo Be Done: ��S�'4�� (y r�� ��Cs��-� �v2 <br /> "7`U.t.� S�<#- r�:�+-+t - <br /> NOTE: W�RING W P:ON-DWELLINGS IS REQUIRED TO FEE �` <br /> BE IN RACEWAYS, MC OR AC CABLE. �` v�i <br /> / <br /> CITY OF EVEREIT LOCAL SALES TAX CODE IS:105 <br /> �� <br /> 1 hereby ceriily that 1 have read and examined Ihis application and know the sanre to be frue and �� �j ���1 _. J� ;_) <br /> cor�ecL AI!provisions of/aws and ordinances goveming fhis type of work will be completed — <br /> whefherspecibed harein ornot The granting o/a permd does not presume to give aufhority to <br /> viola!e or cancel the provisions o(any other slate or focal/a�v regulating construction or fhe <br /> pedonnance o/coi,•'vction. That 1 am aufhonzed by the ownerolthis property to perform Ihe <br /> work lor which appli�r!ion is made and I compty tvith the State Con(ractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> — �``�/- G� �� o �i /j / �7 <br /> / � � <br /> � Date <br /> --- — � <br />