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ELECTRIC�L PERMIT APP�.ICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org F 12d 3-� S Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S-u -�Z <br />CoS-? �'i Lor76c /'r,� +4!/C. <br />P_ROJECLADDRESS — ---- <br />�.',�Noii,,S �oS.Z i Lor•,bc.�/ .gv� E�/�,�efi'� �A �IfSZ°3 `���5s7o_�o97: <br />Owner Mail Address City Slate/Zip Phone <br />Tenant <br />owne�' <br />Electrical Conlraclor <br />State License �dumber <br />S ��no�/C �G r.,: J,/i <br />Proposed Use cf Buildi g <br />Mail Address <br />Mail Address <br />Cily <br />Cily <br />Sta�e/Zip <br />Slale/Zip <br />Contrect P•ice o( Work <br />Phone <br />Phone <br />3�'�+ n�ori%5 �`��SI'&7o•G 97z <br />Contact Person (Plan Revie�v) <br />OescriptionofWorktoBeOone: �G�� It��-✓ ��eC-h�cG/ /3nX ����+t1� Ova—f�fl <br />NOTE: WIRING IN NON-DWELI.INGS IS R[QUIRED TO FE[ <br />DE IN R,4CEWAYS, h4C OR AC CABLE. �� (� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 i <br />I hereby cerfily thaf ! have read and examined fBis application and know fhe sarne fo be !rue and ��Z,��� I SZ <br />co��ect. All provisions o//aws and o�dinances yovem�ng this type o( wo�k will Ue completed <br />whetherspeci�ed herein ornoL 7he �ranting ol a permd does nof presume fo give aufhority to <br />violafe or cancel O�e provisions ol any other state or local law regulafing consfrucficn or fhe <br />pedormance olconstrucfion. Thaf I am authonzed by the owner ollhis properiy fo perfonn lhe <br />�vork lor which applica(ion is made and 1 comply �vifh the Sfate Contrac(ors Law 1827 RCW and <br />296.200 WAC. <br />, �— 3-��_ a��z <br />