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EL�CI"RICAL PERMIT APPLICATION <br /> CITY OF EVEF�ETT QERMIT SERVICES <br /> 3200 CEDAR STP.L=ET, EVERETT, WA 98201 ,l �� �,�, <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � <br /> C u '�c% � -u L�� <br /> .�.21 Z �.n�n,l!�C��,( G��� <br /> PROJECT ADDRESS <br /> � ,� ��11i �LiJ�-''"1 �Z�r'i�- �-{`f'—{9L /� )[` �GI.�LP�1�'(�r .C�� L.tl/4 '7sGS��, <br /> Own r Mail Address City State2ip ione <br /> I �.�^����I <br /> Tenanl Mail Address City State2ip Phone <br /> ��� `tf P�Q�-�', �.lil-�� _ wl�'l�d(e�1�l P 1,�� ���6"�7/ �f ZS•'t��: �l3Z� <br /> rical ConlraClor Mail Address City State/Zip Phone <br /> N y U�4�r�,�5 t�l � , Co� <br /> Slate License Number � Contract Price o(Work <br /> 5,�� ��.,vi.+��� �Zei�. �e,� ���-. �Xs� �i3zi <br /> Propose Use of Building Conta Person (Plan Review� <br /> Descriplion of Work lo Oe Done: 1(J�-LU�4-�. lSh� ��___ <br /> 7� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/y fliat I have read and examined(his applicafion and kno�v fhe same fo be!rue and <br /> correct. All provisions of Isws and erdinances govemmg this t}�pe of�rork will be completed <br /> i whe�her spealied herein or noL The granting o/a pernuf does not resume to give aufhonty to <br />�, I violate or cancel the provisions ol any other stafe or local law reguPting construction or the <br /> perloRnance o/construction. That I am authorized by the owner o(this property tn pe�lnrrn the <br /> {-i� i work/or�vhlch app/ication is made and 1 comply�vifh the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� � <br /> � <br /> �t. �; ' � (, ��G,(� �/���' � q.i;> <br /> ,,. <br /> S�p ia ure Da e . :� �- <br /> I i <br /> .. �� <br /> t' <br />