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ELECTRICAL RERM11' APPLICI�TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE�T, EVERETT, WA 98201 <br /> 425-257-8fi10 - FAX 425-257-8857 - w�vw.everett�va.org <br /> I APPLICATIQNS ARE ACGEPTED FROM 8 AI19 TO 4 PM � _v� , �� <br /> C-� o�'es-bo� <br /> �. ,_ ,, <br /> `r t' Sin-��c;��.�' �� G�.J� <br /> PROJECT ADDRESS <br /> �v��1�-C''�'J'✓1. I V��-�--�."Z��_ -- -- --- -- -- <br /> 'JWner Mail Address �..L 51a1,'u;: Phone <br /> Tenant 1.1ni1 Ar7dress ��� Ciry .r,l2telZlp Phonc <br /> I <br /> /l����d �I�c�{Y:L `-�,c� t�va l'�;� I-,Din���� ��22`1 I 925• Z`t'y��7 � <br /> EleclriCal Contraclor Mail Address Gty StaterZip Phone <br /> �`44S-lNu �5' `' 1 <br /> (Av^c:.,a �Y. — <br /> Stale License Number Coniract Price of Wort: <br /> Proposed Usc o� �uildin�7 Conlacl Person (Plan Reviciv) <br /> � <br /> Descriplion ut Wo�k tc C�c Dune: `-�l.1/�( /�-�/��iL� <br /> NOTE: WIRING W NON-DWELLINGS IS REQUIRED TO FEE <br /> 6E IN RACEWAYS, h1C OR AC CAaLE. <br /> �� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �' ..,- , _ � , <br /> �I'I 1 heieby certily fhat I hace reaJ anA ezarnined this applicafion and.Yno�v fhe same ro Ge fn�e and I�—�'?L'�� C�� <br /> liconecL All provisions of laws and oidinances go��erninp fhis type o(�vork will be complefed <br /> I� �rhether specdied herein or roL The granfinc�ol a perrnd does not resume lo give autho�ity to <br /> violate o�cancel the rovisions o(any other state orlocal lnw reguPfmc�consirur.tron or fhe <br /> perlonnance o!cons ruc(ion. Thaf I am authorized by th�owner o/this propert}�to perlonr�the <br /> work/or��ich��ica ion is made and I conrply�riff��e Stafe Contraclors Lmv 1827 RCW and <br /> 29G.200 AC. <br /> _��_,� �"� ,� 5� i /�>� <br /> Signature �_�— Uate � <br />