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ELECTRI�AL PERIVIlT APPLaCA►Ti�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />�25-257-8810 - FAX 425-257-8857 —www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l'oD� fj�r � A,�c� �v�eti <br />PROJECT ADDR SS <br />�icol(� �Vl�� �V�i/1n('� ic�m� L�2��'{I U�� <br />Owner MailNddress City Slate!Zip Phone <br />Tenant Mail Address <br />City <br />m� i�leC��+c o� i�IZC,6,Ltn�CG1� PO sok $(,gj �� <br />Electrical Contraclor Mail Address City <br />i���o'1)t'(�-E'ryl ���"1J� <br />Slate License Number <br />��5�.�rhCti �10VSC� <br />Proposed Use of Building <br />State/Zip <br />Sta�Z� � <br />`dG'1Cl7. "o <br />Contracl Price of Work <br />Contact Person (Plan Reviev+) <br />Phone <br />Phone <br />�� SRI <br />Square Foolage (If residential new conslruclion, remodel or addition) <br />��?�il ��s und cielF(E o%� �n�C� a.�cl �G�c'. <br />Description af Work to Be Done: �u-�U �� - <br />a, dd %c� �,S a�'�' C� tc,z � <br />� $ �„� ��i-s <br />NOTE: WiRING IN NON-DWELLINGS IS REQUIRGD TO FtE <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hemby certily that I Aave read and examined this a/�lication and kno�v the same lo be frue and ,�=-� � �'� _, � <br />con�ecL All provisions a(laws and ordmances govemrng this type o/work v.�ill Ge complefed � L" �- �' ��,:- � <br />�vhetherspecdied herein ornoL The gran(ing o(a pennd does not presume ta give aidhonty to <br />violafe or cancel the preiqsions of any other state orlocal la�v regulahng construcfion or the <br />perfom�ance o/con$fnichon. That I am aufhonzed by the o�a�ner o/this property (o pedorm the <br />work (or which appbca(ion is made and 1 canply �vifh lhe State Confractors Law 18.27 RCW and <br />�qs �no troac . �: I 1 <br />�� <br />�Jn� � �� ZU/ � <br />