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f , ; . ?.:� <br /> i ,_�,� <br />' b <br />� - ' ^I <br />�, : ' <br /> ` �� <br />� ,.;�ti. <br />' ELECTF!ICAL PER11i1IT �OPPL"CATION <br />� �t-'°�-:: CITY OF EVERETT PERN�IT SERVICES <br /> l:.- <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> I <br /> / L- z ! yl Sf 5-f � c� + <br /> PROJECT ADDRESS <br /> � f�5� O �{ClZ co �Sy f��� J'rrn•�" Ll:e .r�( Gt� 7� ?O ( _ <br /> Owner Mail Addres City State2ip Phone <br /> L. �l � Ve �rY l�l [KIC•� N ��ST��i✓i11tJ�� /(JZ/ 7� �' JT/f<T C` IiC1��'7 't�(" <br /> Tanant Mail Address Ciry State/Zip Phone <br /> yzS-� <br /> �;_vrv Nt��i c c 7�/oc� ��A�r,y.5o.•_, /.;.F� Crc;c��/f 6,.ii S�to'S 71E }15'35 <br /> Electrical COntractor Mail Address City StaleiZip Phone <br /> (UU. �" <br /> �it.rr.i,vc � �Sb�L 3 — <br /> State License umber Contract Price of Work <br /> �«-1 �,�U+- Sfc�� f'�o���t� <br /> Proposed Use of Building Contact Person (Plan Reeiew) <br /> Description of Work to Be Done: /v�� lq t[ (2.� 5,c.,�, �4 .S�-��� S <br /> I <br /> � <br /> NOTE: WIRING W NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 hereby ceRrfy that 1 have read and examinen�his applica(iun and know the same to be true and � <br /> conecf. All provisions of laws and ordinances govemmg this type o(�.vcrk will be comp/eted I <br /> whether speci(ed herein or ncL The granting a a permd does not presume to give authcrity to <br /> violate or cance/the provisions of any other state orlccal law regu(ating construcfron or the i <br /> performance of consvuchon. That 1 am authonzed by the owner o/this property fo periorm the <br /> wak for which application is made and I comply witl�the State Contractors Law 18.27 RCW and � ' <br /> 296.2Q0 WAC. <br /> i� <br /> �–' <br /> � � �' <br /> �n�— Oate I' <br /> �V�(Q -G ��1 <br /> I <br />