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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � �_07 <br /> 3200 CEDAR STREET, EVERETi, WA 98201 3 <br /> 425-257-8810 - FAX425-257-8857-www.everettH�a.org �D703 -d�s <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �vuc, � U< i F: r; S i 2EE i — �f1UIZ�n^� �-�A�L RW1 ��`� <br /> PROJECT ADDRESS <br /> �JJ� �Z._:L.. _.. li. L�.'S I-lt._ <br /> L `I , � ` ` � q <br /> ,. ��LIZI_ rT ��.IY�ti\li1� 11 � �tl.l.F.�.r(_ FV�ill�1 W� 1i:.�i� 1 � <br /> Owner Mail�ddress City Slate/Zip Phone <br /> �-..ac.� A` ���.�.,+� r <br /> Tenanl Mail Address Ciry Slale/Zip Phone <br /> \\':� i:�'�:�2 C�� . i� 1 �uL-I _ .� <br /> (JNT("�l ( Ur-�Tr"1',TJ(1S � ,` i� S-SAT'cF l`.��Q `1�'�'� � ,• <br /> Eledrical CoNraclor Mail Address Cily StatelZip Phone <br /> �v�:,T��c-i tv'� "� R '��`i,S� �:. .� ., <br /> Slate License Number Contract Price of Work <br /> 1 .�J,p MI�R�,,._i <br /> i n,�_.�� �:,C. i c: i ��. L.c C A:i i'J � <br /> Pmposed Use ol8uilding Contact Person (Plan Review) <br /> Description of Work to Be Done: �-U�� �`�`J � r��'�= �����L � `�'� ��` L S �p i Z <br /> �D(�EJJ C�'MF'�Zo2 (:.oan�� Ja �T <br /> .'. _ �1� �.. .. -N C �:1'TI-`C.i lL�•:, �f',i\ ' c:��•; o,ays�.oks� �.��F.a�c d4 IL31S� <br /> NOTE: WIRIIJG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certily thaf 1 hnve read and examined fhis application anA Fnow fhe same;o he true and <br /> correcf. All provisions o/Imvs and ordinances governing fhis type o/work will be cornplefed <br /> whether specdied hercin or noL The granting ol a permR does not presume to give aufhonty fo <br /> violate ur cancel fhe provi:;ions o(any other stafe or lor.al la�v reg�dafirr_q consfnichon or fhe <br /> pertormance o(consfruchon. Thal I am aufhonzed by fhe owner ol lhis property fo perform!he <br /> work l9r�vhich application is made and I comply wifh fhe Sfafe Confractors Law 18.27 RCW and ��/L��{ <br /> 29G:�OO WAC. - t' J <br /> � �/; <br /> ��� � <. ����1 � �, � � ����, <br /> —t SignaWre Date <br /> �—�7�G' �--G�l <br />