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, <br /> ELE�TRICAL P�RMIT APPLICATION <br /> CITY OF EVERETT PE�2MIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982U1 s -�-�-{ -/b <br /> 425-257-8810 - FAX 425-257-8857-www.evereltwa.org ��pb S-� D�i <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��C�.;L�� � {"GG�✓(Lf(' C.0 U �- <br /> PROJECT ADDRESS / <br /> r `�ZS-,�_pu3a <br /> 1J u' �! � � � � � r� � �C-���( �'�cir�e�-l���e �vuz�� �� /�Zol <br /> � <br /> Owner ldail Addrnss City State/Zip phone <br /> Tenant Mxi{Address City Slale2ip Phonc <br /> [leclrical Con��ac�or Mail Address City State2ip Phone <br /> Slale License Number Contrect Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriplion o(Work lo Bo Dane: � IL�= ��� �� rr I��1�'� �{'l`�'�1W�`Cl-t (L'7�— <br /> t <br /> -- --- _ I <br /> NOTE: WIRING IN NON-DW�LLINGS IS REQUIRED TO FEE � <br /> [3[ IN RACE�NAYS, �1C OR AC CABLE. <br /> CITY OF EVERET7'LOCAL SALES TAX CODE IS 3105 ,,,� <br /> I heieby catify fhat 1 have read nnd e.cmnined this applicafion and kno�v fhe sante to be frue and � � i�(.'y ' � U`"i <br /> corror,t. All provisions ollaws and ordinmtces govemmg fh�s type ol u•ork will be complefed <br /> �vhefhe�specilied he�ein ornot The�7ran�in�of a pennd does notl�resume fo gi��o aufhority to <br /> violale or cancel the I�rovisions o�any other state orlocal law re�u ating construc6on or Iho <br /> pe�forrnance o(constmcfion. That I am authorized by the o�vner o(fhis property fo poAorm fhe <br /> �vork lor which applicafion i:mado and I comply�vifh the State Contracfors Law 18.27 RCW ond <br /> 29G200 LNAC. <br /> . _� � ��/f�i..�1(�-r l,��_��� _ - �'� �.y��0 I D -- <br /> i�jnature ( �/ I)"� <br />