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ELEGTf�fCAL PERMlT APPLICATION <br /> CITY OF EVERETT �E�MIT SERVICES <br /> 3200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 �M � .�I I .-� �� <br /> JV �� ���C� 1'h 'e '�' Ct ✓Ci <br /> PROJECT ADDRESS — Q (�j O S �'�� <br /> � � <br /> Y" ��� `� l f �tJ �I � � � -- <br /> OWne� Mail Address City StalelZip PhOne <br /> �� <br /> Tenant Mail Address ;ity Slatc/Zip Phone <br /> �' I��KS C�YC, �3/ �57��s� � �U4, S��nc✓o�.� kJ� <br /> Eleclrical Coniractor ldail Address Ciry Slale/Zip Fhone <br /> �b�-��0�3K� <br /> G L�„� C1��� � � ���s a�, � <br /> Slale License Numbar Contr cl Price of Wo�k <br /> �� PIe >C ` �rs . <br /> Propos�of Bui ding Contacl Person (Plan Rc�view) <br /> Description of W rk to Ba Done: ��l/ h1 �t'�'� U�� �. , <br /> �r ��jC� ���l�rS, <br /> NOTE: WIRING IN NON-DWEI_LINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EYEttETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce�ii(y fhat I have read and examined fhis apFlication and know fhe same to be Iroe and <br /> conecL A'I provisions ol/aws and adinan�es govemin�fnrs type o(�vorh will6e completed <br /> whe(her� ed herein or noL The granfinc�ol a permd aoes not �resume fo give aufhonty fo <br /> violafe :canc 1 fhe Iirovisions of any other state or local la�v rec�ul�fing construr.fien o�the <br /> peAo ,iance o onstruc(ion. 7haf 1 am�t (honzed by lhe owner oI thic propeR}�to pedcnn fhe <br /> wo�k or which pplicalion is made an�!� pl}�wifh fhe Sf. : Contracfors La�r 18.27 RCW and <br /> 296. 00 WAC. <br /> � � s=�i �� <br /> Slgnalure Uato <br /> �- t' u U5 (,�5�,( <br />