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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES C� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �����o <br /> 425-257-8810 - FAX 4�5-257-8857 -www.everettwa.org /Jv�/�p_p5� <br /> ` <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .�5/Z 5,�,,T�! Si . <br /> r <br /> PROJECT ADDRESS � j� p f ��j�Z�'TT j�)2t1�CL. <br /> 9i1wE� c,r,a�t;z -.1- s o✓e.,r ,�A�s c � y <br /> �', ��, o F L�t�ec i% �v�c 7' r l.l./�_ <br /> Own� A1ail Address City Slale/Zip Phone <br /> T�nant 1.1ai1�Adir.ss City Slate2ip Phone <br /> !�!�l�t� E�r c '� .. /�UD ���R�� �,�-".�c,t �/Ctti �!/��'cT% lv/�. f nUlo� <br /> Eletlrical Co Iraclor I.fail Address City State/Zip Phone <br /> �f� LLE �C. l�1 /N/� `-���,f�D o a <br /> Slale License Number Contract Pric�ot Work <br /> yzs-�sa v3�3 <br /> Proposed Use of Duildinc� Contacl Person (Plan Review) <br /> J��//�i� S/�!�/v!/�4r/ <br /> Descrip�ion of Work lo Be Done: _ <br /> �EJ�r��)� /,�cl�c�c��Yl��-> � - .s��-'�� cc� �Z/�r�.c�c�: �'��-c � <br /> �6��O�fl �� . <br />� <br /> NOT[: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN R.4CEWAYS, ti1C OR AC CABLF. <br /> CITY OF E'JERETT LOCAL SALES TAX CODE IS 3105 �-g <br /> 1 herebvi certily fhaf I have rcad and exanm�ed tlns applicnlion and kno�v fhe same fo be hue and ���C`�I � �, <br /> correcC All provisions olla�ta and ordinances�overninc�this(}�pe ol tvork�vill be cemple'ed � <br /> whether specilied herein or noL The granting ol a perrnrt does not rasume fo give authonty fo <br /> violafe or cancei fhe`�ro��isiais o(any other st�te or bcal law reguPting consin�chon or the <br /> perforrnance oI construcfion. Thaf 1 am authorized by fhe owner ol fhis propert}�fo peilorm(he <br /> �ro�k Ior which application is made and 1 comply�rith fhe Sfate Contrac(ors Law i8.27 RCW and <br /> 29ti.200 Ih�AC. <br /> - -�i � '�� /� <br /> '' 't.:,� ��c� �l' /O �1�'��j , <br /> �'� , — <br /> S:gnuWre� Dd�C <br />