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ELECTaIGAL PERMIT APPLIC/�,TION <br />CITY OF EVERETT PERMIT SERViCES <br />3200 CEDAR STREET, EVERE fT, WA 987.01 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROIt7 8 AM TO 4 PM <br />u�.� r� � �J -.'}- /7VL <br />PROJECT AC�RESS <br />! aw <br />Owner <br />Tenant <br />�.c i:���'11("'14)1 ��Z� <br />� : „ /.. <br />i, <br />�7-�5 ���'y <br />Maii AdAress <br />Mail Address <br />>vt� <br />City <br />Gly <br />iv� <br />SlatelZip <br />SlatelZip <br />Phone <br />Phone <br />)t�.-,..1 /'S� i�V�- /va_ Il{ �_.�- �{ iN.�- `%li•i,- vzJ-YSJ".:�'j'. <br />/_.,�.��.�.� /�.Il.-.t-�..�,� — <br />Electncal ConlfaClof Mail Atldress City Slate/Zip Phone <br />� rl ! l' i[� /� ti'! i.. <br />Stale License Number <br />Proposed Use of Buildmg <br />�4 i !->(' • . <br />Contract Price of Work <br />�� ��'> .1; <br />Contad Person (Plan Review) <br />, � - . <br />DescrfpGon ot Work to Eie Done- !t �:l;,t. I_ 1 , C� �_ �t�.�:y' � � � � "� ; , , �1�-` — :� , � `-� . <br />� .� _ <br />_ I�', r ,.-i-� l�� ( :,.—,,..i_. `i;�y� <br />l � " <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 />1 hercby certJy Ihat I have read and eramined (his applicaGon and kno�v fhe same fa be Irur, anA � /�,I <br />r,orrect All provrsions ollnn�s and ordmances goveming this type o�work will be comple,fed '�� � Q� " l.J� � <br />whelher speci/ied he�ein or noL The granting ol a pernut does nof xesume to give authority fo <br />violafe or cancel the provisions o/ any other sfate or local la�v regul�ting consfruchon or the <br />pedormance ol construcfion. That I am autherized by the owner ol this proper7y (o peAomi the <br />n�oiF �or �vhich aF ��licatwn is rnade and I comply �vith fhe State Contractois Law 18 27 RCW and <br />296200 WAC. <br />�� � , ��/U, i I <br />� -:__ <br />