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� <br /> ELECTRICAL PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 7� U(apPr R��G�1 P R� LaT I <br /> PROJECTADDR S <br /> DI1R �niTF2 AliSdS �n�L IRNiO 2A�A�(p,L✓ ��OZ ���ti�Nu�oe� W.4�9A03G '�'2S`• 77S•9S_�''/ <br /> O�mer MailAddress City State2lp Phone <br /> Tenant Mail Address City Sta�elLp Phone <br /> Fer� ' r �I t �r'r PO 6ox 12G68 m'lIP,1ek WA/9ROS2 �/2.S•S'08•D�(�d <br /> Electncal Contraclo� Mail Address Ciry State2ip Phone <br /> �rr�' e� n{,�iYtr � ,� OOO.Oo <br /> Stale License Number Contract Price of Work <br /> � � �/P <br /> �Ar, ��v hevHC /'I �o�N tel`rj.✓ <br /> Prop ed Use of Buil—d� Contact Person (Plan Review) <br /> DescnptionofWorktoBeDone: �1IPa� CUn1ST-rUGf•4 �/ � ��l�^��L'41 /�t�ST��� <br /> � <br /> . , � . .D,� vn �Nn �, P /rv / r� T�� <br /> NOTE: VNRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT I.00AL SALES TAX CODE IS 3705 <br /> I heraby cerfrty that I have reod and eramined(his application and know tbe same fo be Uue and <br /> cared. All provisions ollaws and ordinancos govern�ng this type ol tvork will be comp/eted <br /> �vhether specihed herein or not. The granting of a permd does not presume fo give authority fo <br /> violate or cance/thepr ovisions ol any other state or Ixal law regulatnrg construction or the <br /> peAormance of con¢fruction. That/am aufhonzod by fhe owner o!th�s proporty to pedorm tha <br /> work!or which apphcation rs made and I compty wifh fhe Sfate Contiactors Law 1827 RCW and <br /> 296200 WAC. <br /> ����o,;�,� �� g 6 <br /> Signa ur Dale <br /> � aCoa3 -G�( Z— <br />