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� . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDf,R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROPJI 8 AM TO 4 PM � _ � t.� �06 <br /> C 1�� <br /> P �� �J <br /> `.�(�b MPr'Q-�1n�C 1/i C� (J�.��C UNl"�' (Z /y <br /> PROJECT ADDRESS <br /> L/��cC �,.�� Iao�eS <br /> Owner Mail Address City Slale/Zip Phone <br /> Tenant hlail Addross City Slate/Zip Phone <br /> ��25 30�6 S�5� <br /> � ,�,Mt� C� c•'c�2u � 2a3 lsr 5� rv� S'1�I�Nl�JO� wA ;�'-��2 <br /> Eleclrical CoNraclor Mail Address City Slate/Zip Phone <br /> �uMM1C 1 �UILZ, �j,o;,;, <br /> State License Number Contracl Price of Work <br /> �-e 5��2- <br /> Proposed Use of Duilding Contact Person (Plan Review) <br /> Doscriplion of Work lo De Done: W I F-L n)E � �J�� � I�MT" ��V�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABL[. <br /> CITI'OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily that/have read and examined(his appficafion and kno�ti�fhe same to be true and <br /> correcL All provisions ollaws and ordinances governing(his type o(ivork uill be completed <br /> whether speaficd herein or noL The granting o(a permit does not presume fo give authonty to <br /> viola(e or cancel the provisions o(any other sfate or locdl la�v regul<�ting consWction or the <br /> � pertormance of construction. lhat 1 am authonzed b}�Ihe otvneroRhis property to pedonrt the <br /> �vork Ior which application is rnade and 1 cornply�vi(h the State Contractors La�v i8.27 RCW and <br /> 296.200 WAC. <br /> �� � ----- 6- i �i a � <br /> Signature Date <br /> F—OCuO�-IC)1 <br />