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ELECTRICAL PERMIT APPLICATION <br /> � <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 CEDAR STREET, EVER[l"T, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wv,nv.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 tiM TO 4 PM <br /> ���.� ,- �, � ,.� � U�E � n <br /> PROJECT ADDRESS <br /> ;: �,,,�•���,,r�D <br /> l�' L--�� *Jt-�'�—� J�'ti � l�'«b�. Ri� Fik'����f u �H 9�� — <br /> O�d;ner M11mll.ddu,ss Giry SlalciZq> Phonc <br /> Ten,^nt L1nil Addmss Cdy Statc/Zip Phono <br /> �iC• f✓c ER � Cf�P '�n1C �(oflb `��AnP et/M� STh"(thNnuh �1/� � ���.� <br /> Elochical Con�raclor htai;Address Clty � SWteiZip Phone <br /> 5-f r�v`�—��`•' ( T _ (s,��.�. L' i) <br /> State Li�ense umber Conlracl Price of Work <br /> L '��'� �( C� <br /> P�roposed Uso of Building Contact Person (PI2n Review) <br /> Description of Work l0 6e Done: ?��'�� �'� `-i � I �; (� I' �i 1 � n 1 - � �-1(��' �1 �S <br /> I <br /> NOTE: W IRING IN PJON-DW ELLIN��S IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � I CITY OF[VERETT LOCAL SALES TAl(CODE IS 3105 ��j <br /> 1 I I hercby ceriify thaf 1 have read anAexamined fhis applic3tion and kno�v the same fo be frue and �u��� ' l` � <br /> r,oned. All provi.sions o/laws anci ordinanc�s govern:ng Ihis type cf u�ork will be completed <br /> whefher specilied herein or not The granf�ng ol a pennd doe�+��of �resurne fo give aufhonty fn <br /> vio/a1e o�cancel tlre provisions o!anp o�her stafe or locai law ragulafing construchon o�the <br /> performance o/consfrucfion. Tha!1 am aufhonzed by Ihe owner ol this property fo peAorm fhe <br /> work.�r�vhi�h eppiication is m�de and 1 compty�vith the State Contractors Law 18.27 RCIh'and <br /> 296200 lM1%AC. <br /> � %�- -7'�/ _. r' :�'�,�, ., �/- � �- o � _ <br /> Signalure � ' Date <br /> I <br /> I I <br />