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ELEC�RIGAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 (.��-6 —D7 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> C ���04 --0�1 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 32o Z <br /> 3�T1 �Om1�,3rt� �V1L. (—�� �se ', s rv�.rk.ed 3202� <br /> PROJECT ADDRESS � <br /> (za 613zg=Jy � <br /> �-�cN2 CYd�n,¢,� I"1oo 2i5}flveS , #'loo �.u1� eu1A �$ 1�1� <br /> Osvner Mail Address City Stale/Zip Phone <br /> Tenanl Mail Address Ciry Slale/Zip Phone <br /> 4Z5'�335. <br /> Snohom��i� �.lec�r�c. IrC Pb604 Z-Ig S�nc��1(a'11lSln vJA ��2�11 -��s� <br /> Electrical Conlrac�or Mail Address Cily StatelZip Phone <br /> SNo ,--4�E�L1� � Pv.� <br /> State License Number Contract Price of Work <br /> Proposed Use of Ouilding Contacl Person (Plan Review) <br /> Description ot Work l013e Done: �11��, ��pQ..1 -�Oe baS.�P'Y��r�..� <br /> INOT[: WIRING IN NQN-DWELLINGS IS REQUIRED l'O FEE <br /> DE IN RACEWAYS, MC OR AC CABLE. <br /> '`�JS . oU <br /> CITY UF EVEREl7 LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily;hat 1 ha��e read and ex�mined Il�is application and know fhe same to be frue and <br /> cerrecL A/l provisions o!laws and ordinnnces governing this type o�wo�k will be complete� <br /> �vhe0ier specdied herein or noL The�ranimc�of a pennd does not resume to give au(hrnty;o <br /> violafe or cmicel the provisions ol any ofher sfafe or locai law reguPtinc�construction or the <br /> perfornrance o/consfruction. That 1 am authorized by the o�vner of this property to perfonn fhe <br /> work for which applicafion is made and I comply wi!'i fhe Sfate Contractors Law f 017 RCW and <br /> 296.200 INAC. <br /> �,q, 4�b D� ��� <br /> , _��� <br /> ; <br /> Si iatu Date <br /> . i <br />