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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �-, _p��-C�(,; <br /> ;� �� ;�� ;er P�,�� � ��� ��l���rM;��,����,s <br /> ��� O �i�, �,� ; zr ��.� ��, E�s��f �1l/,-' 9�u�� <br /> PROJECT ADDRESS <br /> ��,, c: / / ) / / 7s'S,� �,SY�.�,Sj <br /> Coi�S?rvcT,Gv� �o�J.l6 /-/vicrq /-f�P /��cr�l, -S�7Gr�/, �v��'� `��/�� <br /> Owner Mail Address Ciry � Slate2ip Phone <br /> Tenanl MailAddress Cily Slale2ip ��a G��Phene <br /> i_=l�•c froN,� 6�/S' <br /> i� -1P � ,�-n Svs��^i��c �'G i3ox S�� ��lco ���,/�P l/l�/� 9�G %o� _ <br /> ElecUical Conlraclor Mail Address � City State/Zip Phone <br /> I ry /._. <br /> `. /� •. �'� /h CC <br /> � <br /> .'`G�c?..�5 �I�?:[�F � � `"� � GGG_ <br /> State Licrnse Number Contract Price oi Work <br /> ///li��� / �/14 �%i _ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to �e Done: S r' �'o v7 D� �G i..� I�O�7-�iCi� ?-� !'(� <br /> cl �, r�� . �� �P <br /> NOTE: V`11RING IN NON•DW ELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerlily fhaf 1 have read and ezamined this application and kno�v fhe same to Ge true and <br /> corcecL All provisions ullaws and ordinances govemmg th�s fype o(work will be completed <br /> whelher speci�ed herein or noL The granting oI a perrnd does nof resume to give authcnty to <br /> viola(e or cancel fhe provisions o/any ofher stafe or local la�r reguPting consVucfion or the <br /> performance o/co+isfnicfion. Thaf 1 am aufhoiized 6y the o�rner ol flus property fo pedorrn fhe <br /> work lor which applicafion is made and 1 compty uiUi the S(ate Confractors Law 78.27 RCW and <br /> 296.20011'AC. � - <br /> � <br /> i " ��. l_/� � � � �� - �'' G'� — <br /> ipnaWre � Dale <br /> �� <br /> Fc� �a -��(� <br />