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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org 9`0a <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C ��D q <br />P—+/R/O�J-{E�CT ADDRESS <br />Owner Nail Adcress City State/Zip Phone <br />'c-anl 'Anil Address City Slare/Zip Phone <br />si-CA�Ci1 ./.14p /'.Anc1 r�L-lil.t.'r—I{'�'ti Vibvauiir11 kx_Wr -S . ,G,—g33A <br />_lec'lial Cont allot Wil Adcress City Swefzip Phone <br />Z�/=LLl3C CyrS�. ` '7,W s-3- <br />Stale License Numcer Contr= Price of Work <br />Propose-- Use of Builoirg ,,Contact Person_ (Plan 1Review) <br />Description of Wor<to Be Do-e <br />NG T E: WR:NG IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />t hereby certify that 1 have read and examined this application and know the same to be true and <br />rnm All pmvisians of taws and nrdinances govemrng this type cf won: Hill be completed <br />wte!her specified herein or not. ; re granting cf a penrnt does not presume to give authority to <br />violate or cancel the org visions of any other state cr local law regulating :tonstruchon or the <br />performance of construction. Thal I am authorized by the owner of this property to perform the n <br />work for which application is made and f comply with ;he State Contractors Law n8.2T RCY! and <br />29620D WAC. <br />�7 - o <br />ti•crature - Date <br />, d L0960GL09E 31110el30OW3 e£9:0t tL LOdeS <br />