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EL�CTE�ICAL PERMIT APPL�C�TION <br />CI'i'�' OF EVERETT PERMIT SERVIC:ES <br />3200 CEDAR STR.EET, EVERETT, WA 98201 <br />425-�57-8810 - FAX 425-257-885? — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />. '�' � ,� <br />- � �'l f �_? 1-�` � � / ! �"stJ C�= <br />PRUJECT ADDRESS <br />Qwner <br />Mail Address <br />�l � z�` � <br />��� � <br />3tateiZip <br />�/ Z C-2�7v-�3 (l <br />Phone <br />�\l,� .� �-�-�-u< ��-� � 1C, �,� �:- <br />Tenanl M1tail Address City Sl�te/Zip Phone <br />�_' L- `z.��i_ L 2--� Z'��acL�o—� 6'�� t� � 3 � 2 C e�e� cJ� k�� i <br />Eleclrirol Conlraclor tdail Address Gq� . State/Zip Phonc <br />�-E2C � L ��- `� ��' L� <br />Stalo Licerse Num6er <br />!sY <br />C� o -� <br />Contracl Price oi Work <br />l-1,� �� ",, C �,�� c�= r� �� J ��/� 34 � � — <br />Proposed Use of Building Conlacl Person (Plan Review) <br />Description of L1'ork lo Bc Dona =� � �� S Y i�� ��=v1' �"" G��. [lf�'1/' � U�_) �Q GL�-� t/� S <br />,� i`! S Y.� Z''c U o v �; �I (. l� <br />NOTE: WIRiNG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEW �1YS, MC OR AC CABLE. <br />CtTY Of EVERETT LOCAL SALES 1'AX CODE IS 3105 <br />1 hereby certily that I have road and exarriined this application end know fhe same to be true snd <br />conecL All provisions ollaws and ordinances govemmg this 1�. pe o/ �rork �vL'I be cnmpleted <br />�vhether specilied hercin or noL The granfing o( a pernut does ri�t �resumc fo give autltonty to <br />violafe or cancel fhe pro��isions oI eny ofher slafe or local law regulating consfn�chc•n or the <br />perfonnance o/ constructicn. That 1 am authorized Gy fhe owner o/ fh�s propert}� to peAorrn the <br />work (or whrch application is made and 1 contply wi�h the State Contracfors La�v 1827 RCl-Y and <br />296.200 WAC. <br />�) ���� .� � , ?-Oc G <br />FEE � <br />