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�LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.evereltwa.org a- �2-g'07 <br /> C-a 7D a--+�0 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��2�� E XA�1��,2 �JA�� <br /> PROJECT ADDRESS <br /> C�C-,o�C-�C- ,Sc,�-l��h�q/U�, ) ��7,�J �, x"VG��CGL lJ��� E�iF.2C:� ��ZD`� <br /> Owner A4ail Addmss City StalelZip Phone <br /> Sqn;� �ZS� 3s���-��5' <br /> Tenanl Mail Address Ciry Slate/Zip Phone <br /> C�� �/l ��� <br /> Eleclrical Contraclor Mail Address Ciry Slate/Zip Phone <br /> State License Number Conlracl Price of Work <br /> S/.'JGiL! �/�l^� lLy �l ! . <br /> Propose se of Building � Conlacl Person (Plan Review) <br /> Descriplion of Work lo Bc Done: /��l1�i°I, ' X �Y//��:� �i,/WL ' /��Q��%�" �"1 <br /> �2�i�:�' ��ii�'C.=c�i—i��T� � /lFi'l�Fr�. G�c.�����,��/�i/�� <br /> �'��v� �/�r17"_S <br /> NOTE: '.NIRING IN NON-DW ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 hereby ceriilylhaf I have reaA and ezmnined fhis apphcafion and kno�v fhe same to be Vue and <br /> correr,f. All provisions ol la�vs and ordinances goveming fhis fype o/u-o�k will be completed <br /> whefher specilied heiein or noL The granting ol a pernuf does not�iesurne to give authority lo <br /> violate or cancel fhe uovrsions ol any other stale or local law regu atine�construcfion or fhe <br /> perfonnance o/cons�ruction, haf 1 am aufhor¢ed by the owner o/fhis property fo perlorm fhe <br /> �rorlc Ior�vhich applicafion is rn vde and I comply wifh fhe Stafe Confraclors Law 78.27 RCIN and <br /> 296.200 WAC. / <br /> � ��- �,� ��� 0� <br /> Si nature Date - � _ � � �-� <br /> .- �`�,�..� <br />