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( � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 a ,..1C�_Og <br /> 425-257-8810 - FAX 42r257-8857—vwvw.everettwa.org <br /> CoSo�-lo6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �520 nake.� Av�: , Ev� rc� H � Lv� 9RZG1 <br /> PROJECT ADDRESS <br /> �_1,op.�t�� �� o�,� �i,c,- (Hzsl <br /> ��:r��� � v > �� Ga�e.e �lv� Lvc�r�° t-L c.<J�1 �BZoI zs9• �ioia <br /> Owner MailAddress City Stale2ip Phone <br /> Tenant Mail Atldress Ciry State2ip Phone <br /> (3(,�U� <br /> T�jr�,ic�r' Ll�'�1�'�C T�r- �?1�-12.`�t - IL;�fh�1vC �'E:l»o/�rc�f L(J/1 �(v3- 3lvan <br /> , <br /> Electncal ContraCtor Mail Address Ciry State2ip P�one <br /> 1/v7E Y E T_UO'�C i� � �6 ,•. <br /> State License Number Contrad Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � ! � � <br /> Description oi Work to Be Done: Cxy�'•� r�X•5rjti� � � ��v�' Si�i✓ <br /> �io��ti� �,, �� r� ��> , <br /> , <br /> NOTE: VNRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. i—�. <br /> '�y ='— <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby cortily thaf f have read and examined this application and know fhe same to be true and <br /> correct. All provisions ol laws and ordinances govemmg this type ol wak will be.complefed <br /> whether specified herein or not. The granting of a permrt dces not presume fo gne authonty to <br /> violafe or cancel lhe provisions ol any other sfate or local law regalating conshuc6on or the <br /> peAonnance o/consfnictiai. That I am authonzed by the owner o/fhis property(o perform fhe <br /> wak!a wbich app6cation is made t+nd 1 canpty with the Stafe Cantracfors Law 1827 RCW and <br /> 296.200 WAC. <br /> / ^ �, /'��' I � � U�� �? � �, <br /> LC�ignat� Dale � �� _ I � <br /> � - <br />