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� <br /> ELECTRfCAL PERMIT APPLICr�TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Zl U� w � �-�� � <br /> PROJECT ADDRESS <br /> MAr O I' �- �G�f.✓ <br /> Owner Mail Address Gty StateZp Phone <br /> Tenanl Mail Address City Slate/ZJp Phone <br /> \ k���,�� E��� .� �iv3rc���� c��^c.�-w�-�Sz�3 yzss3�3�$ <br /> Electrical ContraClor Mail Address Gty Slate2lp Pbone <br /> C11-U � C�� � Z� Q� <br /> Slate License Number T Contract Price of Work <br /> �.cw� C�i,t,rG In r � � <br /> Proposed Use oi Bullding Contacl Person (Plan Review) <br /> �iZs s-3v3 � 3 � <br /> Description of Work to Bo Dono: }�(%�/u2_ 1 C �^^'LGI'�— / `-� N e�✓ �-�G �er S <br /> lJ- //7 G�/ /C� S i���C� � �C C �G r S / 1E'c w � .t 7 i�✓Yn�1 G �l_ <br /> rrcv� �� <br /> NOTE: WIRIlJG IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> � 1 hereby certi(y that 1 have read and examined this epplication end know the same to be frue and �\`�� , ��� <br /> correct. All provisions o/laws and ordinances goveming thls rype of work will be completed <br /> whether specified herein or not. The g�enOng ol a permif does not res�me fo give authonty to <br /> violate or cancel the provisions ol any ofher state or local law reguPting construction or the <br /> pedormance o/construction. That 1 am authonzed by the owner o/this�roperty fo pedorm the <br /> work lor which applicafion fs mede and 1 comply with the State Contracfors Law 18.27 RC W and <br /> 296.200 WAC. <br /> �_ 1Z J °� Z �/c 1 <br /> �l- , ,. <br /> Signature 1e <br />