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( <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETI', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.erg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />/ <> r ' J <br />''�-Ir ,/��(�(�_,lI"�U�_ t_vr�.�E I�,�.L- J <br />PROJECT ADDRESS <br />Owner <br />TenaN <br />t'� �`,� l l�)i`�� I <br />�d il Address <br />A1all Address <br />City <br />Cily <br />�`:�i-L,�� •i `'"J� <br />Slale/Zip <br />Slale/Zlp <br />Phone <br />Phone <br />� � 1 i��''��-�'� � �� c �� i �. "] �i I � 5Z%'" �51 N�V '�-�c,.�u���'tL�r 1,:.!f1 ?���C' • lr.)-�( � �C'C�9 <br />EIeCUic31 ConlraCbr Mail Address Cily Stale/Zip Phone <br />C Lla 1'_�. C�� l Qa `f l=`I <br />State License Number <br />Li�nCL'il <br />Proposed Use of <br />'.�,` ��� � <br />Conlracl Price o( Work <br />ConlaclPerson (Plan Review) <br />i <br />Descriplion ol Work l0 6e Done: I� ����„l�A ii;��l�i i.. ��� �'c� .�;. i.�. ��:. ,. �;._, �� � � ��.i -1 i�- �1..�� � ��� <br />11: i. <br />NOTE: V�'IRING IN NON-DWFLLINGS IS REQUIRED TO <br />f3E M RACEWAYS, MC OR AC CABLE. <br />CITY OF [V[RETT LOCAL SALES TAX CODE IS 3105 <br />1 heieby certily fhat 1 have rr,nd and examined (his applicafion and know fhe same fo be frue and <br />correct. All pro��isions o( la�vs and orrlinances 4oeenung fhis fype o( �rork will be cornplefed <br />�rhe:her spea(ieA herein or noL The granfing ol a pemuf does nof a�esumo to give aufhonty fo <br />viola(e or cancel fhe �rovisions ul any other stafe or local la�v regulxfing consfruchon or fhe <br />perfermance o/ cons�rucfion. Thaf 1 am authorized b�� fhe owner o! fhis property fo perfonn fhe <br />work !or n�hich npplication is made and I cornply wifh fhe Stafe Cenfractors Law 18.27 RCW and <br />796200 IM1�A C. <br />i � . . <br />i' � <br />� tL., � �, _ > I , ._ . <br />`T� ��-�> � L' <br />FEE <br />Fo8a9 I31 <br />