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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 —v,nvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��/0`U7 <br /> [- v7U)�6� <br /> ' / �� -�' �—AW Ic�'L., �-tivL�— <br /> PROJECT ADDRESS <br /> � <br /> c7�fl�J� lS�ZG M'}v-' `�r �iAlU� c.Qc.rr2' � `�sSUIZ �lZ) — 3> <br /> Owner�y�Tt�L'�� ra:,��inddr�ss ,SUtTt= Zld a�y si,ierz�p ai,on�.z�,, <br /> TenB�H tdaillddwss City State;Zip Phone <br /> ('(�C'� �'t�-e��L 3z�z icr�`'Sr sF I�,rLett �r— `�ZoY 4��—�s }— <br /> Eleclrical Conlr2clor Mail Address Cit, StalelZip Phone(� � <br /> �z� c��� �� l�' �� 3 3cno "= <br /> Stale License Number Conlracl Price of Work <br /> CO,•.)OMI�Ulv�S St+flvNC �nz��=L-�� <br /> Proposed Use of Duilding Contact Person (Plan Review) <br /> Description of Work to�e Done: - ��-��L- l.�-��L � 5 <br /> � i:J tl-�� �(�-��`��� <br /> r � . <br /> , <br /> NOTE: W IRING IN NON-D\NELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> 1 <br /> , � \ � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heieby ceriily thaf I have�ead and examined this application and knore fhe smne to Ge frue and <br /> cerrecf. All provisions of laws and ordinances govermn�Ihis lype o!�rerk u�ill be cornpleted <br /> n�hefher specilied herein or noL The granfing of a pernut does not presume to give au(honf}�to <br /> violafe or cancel the provisions al any ofher stale or local la�v regulafing consVucUon or fhe <br /> perlormance oI consfruchon. Thaf 1 arn authorized by the o�rner o/fhis prapeii}�fo peAonn the <br /> work lor which appli afion is made and I cornply with Ihe Sfafc Co�llracrors Law 18.27 RCIN and / <br /> 296.200 WAC. <br /> '� � <br /> , - /� �j�(��- ��d ��- � <br /> nat r Date <br /> � <br /> 1 <br /> � <br />