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� ELECTRICAL PERMIT AePPLICAY90N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEkETT, WA 98201 <br /> 425-257-9810 - FAX 425-257-8857 — ����.vH,�.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `� -�- S-or <br /> l_Z_�=`1 j iao� A�� , L=..:�,2`:�� ���:�� <br /> PROJECT ADDRESS <br /> "�t� ��C�tw:F��l �--ZU' 1 S4�'\>� \�.Vt �vc1Lc.T l �{'t1. �'oLC:\ 112� 3::F,4.�-"r:r:. <br /> Owner Mail Address City Stale/Zip Phone <br /> 1v � <br /> Tenanl Mail Address Cily Slate2ip Phone <br /> ����� �`y 1�Fs�1�.-.er '�o g„� Z1Z3 r�a�c:t��.-..s i� �h!A 9�[Z`�7( �t25"3Y l oHo� <br /> Eteclncal Conlraclor Mail Address City State2ip Phone <br /> Ev�ti� F r=H�l�`�M'7 ��z,.�� <br /> State License Number Contract Price of Work <br /> ProposeJ Use of �uildinp Contact person (Plan Review) <br /> Descriptioa of Work�0 6c Done: _��.',':���-.�� \ia��-��-`a��. �nl�C2�_. <br /> NOTE: WIRING IN NON-DWELLINGS IS RE(ZUIRED TO FEE <br /> BE ItJ RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COCE IS 3105 <br /> � 1 hereby certi(y fhat I have read and examined this applicafiai and kncw the sarne(o be true and <br /> � conecL All provisions ollaws r�nd orAinances govennng fh�s type o/�roN,<<vill be complefed <br /> I whether specilied herein or not The granfing ol a pernuf does nof presume fo give authonly lo <br /> I violate or cancel fhe Proviaions ol any other s(afe or lecal law regulating cons(ruction or fhe <br /> i pedomience o(constiuction. That 1 am authonved by the o�rner ol fhis property fo peAorm the <br /> � roork lor which applicafion is made and I c:mipiy�rifh the State Confractors Law 18.17 RCW and <br /> 29G.200 WAC. <br /> � �'�ZS�O l., <br /> I v�:�ac ��._=� _ <br /> ignature Date <br /> � l L u� . i i� <br />