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I ELECTRICAL PERMIT APPLICJ�TiON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -vnvw.everett�va.ory <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TQ 4 PM 7�/O -(�'1 <br /> 7�'' fi ] <br /> .J�� �%� �l-C��:vL`�.-r �7-Li-cL. <br /> f ROJECT ADORESS <br /> � . �� �'�::_,_,�,_ <br /> ,I�: y_C �-«:� c, - �i<'S-�:s�- YT2� <br /> O�vnef Mail Atldress City State/Zip Phone <br /> Tenant Mail Address City SIa�e2ip Phone <br /> ��/�C C� �Lf�7�,E;�C f'v� S�fs' C�h%�u� f g/l l��. �� S G�Z <br /> Eleclrical Conlractor Mail Address Cily SlatelZio Phone <br /> � �-i'��,�f5 L f77GZ- .,� zfv <br /> Stale License Number Coniract Price o(Work <br /> I � <br /> �_'%`� �-Y%�`-�-�C_� � ' .,.��t�, <br /> Proposed Use of�uilding Con!acl Person (Plan Reoiew) <br /> Descriplion of Work lo De Done: s�- !/ �J�/�� ��2 �4y Q�_ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC�WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby cmTily Ihat I have read and examined this applicalion and kno�v fhe same to be true and <br /> currecf. All provisions ol laws and ordinanr.es 9ovemin,q this type ol wark�rll he completed <br /> ; �vhelher spealieJ herein or noL The granfing ol a pernut does not nresume to give authonty to <br /> �-iolafe or cancel the provisions olany other state or local la�v regulating consfruction or tlie <br /> �� performance ;l construcfion. Thaf I am authorized by the n�vner o/this property to perlonn the <br /> work Ior which application is made and I cempl}�willr Ihe Srate Contractors Law 1827 RCW and <br /> II 296?00 WAC. <br /> �c:,'�,,_ ` ���c�;,CL�-t-G'�L�1-z. �.'� �Gn —�J � <br /> Signature Da�e <br /> � ���,�- ��- <br /> � , <br />