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E�.ECTRICAL PERMIT APPLICA710N <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — www.everettwa.oro <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3�� ��� - �� '� � ' � <br /> :� ' ��� ' ��� �� <br /> PROJECT ADDRESS <br /> �iil��l� ]�� � � �r ., � - ' �' i� c, ' �_'_ `t r' ' <br /> ; <br /> Owner Mail Address City State/Zip Phonc <br /> Tenan� Mail Address Cily State/Zip Phcne <br /> (�.� i l.;iv.� �:� <br /> Eleclrical Conlractor Mait Address Cdc stats-Lp rnem, <br /> Slale License Numbr.r Conlracl Price o(\NorY. <br /> Proposed Use ol 13uildin�� Conlact Person (Plan Review� <br /> DescriplionafWorkto6eDone: _j��l � ���-� lv���'•�' ��'`���C-� <br /> NOTE: WIRItJG IN NON-DWELLINGS IS REQUIRED TO f-EE <br /> B[ IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i !hereby certily fhaf I havo read and examineA fhis applicafion and kno�v the sarne to be Vue and �"� � ) ����'� _ � <br /> correcl. FlII provisions olla�vs and ordinances gov�rnin�fhis type of u•ork will be compfeted '— �' � �� ��" , I ��'J <br /> u�hefher specified herein or noL The granting o(a pernut does no( �resume fo give aufhorify to <br /> violate or cancel the irovisions olany ofher state or local l���s regulafirg consWction or fhe <br /> perfomtance o/cons�rucfion. That 1 am authonzed by the ou�ner ol this preperiy fo pedenn fhe <br /> work lor�vhich application is made and 1 comply with fhe State Contractors Law 18.27 RCW and <br /> '196.200 WAC. <br /> 'y: � '_ li •� -- .� i � � ,-� C' ��� L/� �, -� �. � ���;; <br /> r ,� � � ' t � l �� L, ✓� �� 1 � r ��c -�j �._ � <br /> SignaNre Date � � .-- � IA ,/ ��t� L%'�L. <br /> ] r� � �l� �-°� � <br />