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� <br /> f <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRF.ET, EVERETT, WA 98201 /�/3-/D <br /> 425-257-8810 - F.4X425-25i-8857 -www.everettwa.ory C'�pv /- 030 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '>�( �7G: I�(���-�-��n �,��_ <br /> PROJECT ADDRESS <br /> �(� �`t�( I ��L �C�cI�� _ <br /> Owner fdail Address City State2ip Phone <br /> Tenanl Mail Address City Slate/Zip Phone <br /> �ti li�� r�( ��r-(-�, i i��l�, ���fG� l�,�2. �vF �� S c� �111�" <br /> Eleclrical CoNraclot A4ail Address City SL+IelZip� 7 Phc�eo <br /> C�i�zZS-�'j� 7 <br /> _ l�s��•h�-s�-^�a ��� �, ��� <br /> Stale License Number Contracl Price of Work <br /> ��-��S�C'�� (n �l/_� � <br /> Proposed Use of Buildinc� Contacl Person (Plan Review) <br /> Description o(Work to Be Done: �{f�� i�_ (.c,eJ S�L� l ll'� ��T�( )-�=-C i2>J�-�/ ��n��(j y� <br /> �.�%..t <br /> NOTE: VVIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAB�E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heroby c;ertily fhat 1 ha��e read and examined fhis app/icntion end hno�t�Ihe same fo be true anA <br /> correcL All pro��isions o/laws and ordinances govertnng this t}�pe oI work�rill Ue complefed <br /> �rhether speafied herein or noL The�ranfin�of a pernut does nof presume to give authonty to <br /> violafe er cancel the provisions olany other state or local la�r re�u/ating constniction or the <br /> pe�Pormance of const�uction. That 1 am eufhorized by the o�rner ol fhis property fo perform fhe <br /> work for which applicafion is made and 1 comply�rith fhe Sfafe Confractors Laiv 18.27 R,CW and <br /> 296.200 Vl'AC. <br /> � ' /� �� <br /> �=' � i/« /i � ' �� l <br /> `-,_ C___- � <br /> Sipn,duie Da�e <br /> ) __ --_ - <br />