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ELE�TFtILAL PERMIT APPLlCATION <br /> CITY OF EVERETT PERMIT SERVICES rb ��y_o� <br /> 3200 CEDAR STREET, EVERETT, 1NA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �dglO—�� 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Z t 1�l }� � /2 � y rQ I . —�s', <br /> PROJECT ADDRESS � <br /> ��v / <br /> �lnl l�� B �Lo 7"(-���5 <br /> O�vner Mail Aadress Cily �tatelZip Phone <br /> Ten2nl Idail Addross Gty State/Zip Phone <br /> �{ZS <br /> �vR�u`�nc i LCrcT��G c�sq SP�2Jc� ��1�moi.aDS q,sjoL� z18-Ga�� <br /> Eleclrical Conlraclor Mail Address Cily StatelZip Phone <br /> ( ill (Z ✓1.l'�' 1C7 ,�j''�y'!�F <br /> Slale License Number Contract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriptian of Work to Be Done: �LJ��� {'� ji C (^�� �� �G�L� __ <br /> � � <br />..� <br /> NO'i E: 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 /> I liereby certi;y thaf 1 have read and examined this application and know the same to be true and <br /> cormct. All provisions ollaws and ordinances governmg this type el work�wll be complefed <br /> whether speciGed he�ern or noL The granfing of a penmt does not reswne to give aulheriry fo <br /> violafe or r,ancel the provisions of any other stafe or loral lmv reguPting consfruc6on or fhe <br /> perforrnance oi consi;udion. Thaf 1 am aufhorized by Ihe owner o/this property to peiforrn(he <br /> work lor which applicafion is made and 1 coniply wdh f6e Sfale Con!ractors Law 1827 RCW and <br /> 296200 WAC. � <br /> _ � _� _ � /�D � ,� > <br /> Si7naWru Date � � -� <br /> � � �' <br /> � <br /> I_.. .. . . . . . _ _ . _ _.. ._-------�--_._ <br />