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ELECTRICAL PERMIT APPLICATION <br /> CITY OF E'iJERETT PERMIT SERVICES <br /> 3200 CEDH� 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 /> l�r,�� �l/5�F _�sf- ✓�.��f, cJ12. <br /> PROJECT ADDRESS <br /> V�r 1 Zov� .t-1/'c�.� GC��� <br /> Owne� Mail Addr^es Cily StatelZip Phone <br /> V�rf2av� �rfc� - <br /> Tenant Mail Adc'ress Cily StatelZip Phone <br /> Ev-�z4n ��ksedi ��le ---- �✓es<'Tl� (,+�1`� __ <br /> Eleclrical Contraclor Mail Address Cily State/Zip Pnone <br /> }�l��� V��S-z��9S�� <br /> Stale License Number Conlract Price of Work <br /> �IPC��'tMuHlcol"�owJ „�K s /' �G(SI <br /> Proposed Use of Buil ing Contact Person (Plan Review) <br /> Descripticn of Work lo Be Done: `�i. � oL u�;��.�< t� •/.� a/o.,s �.7v-�� ��w� :�,oi�cr �'r tJ-��� <br /> v4'�a�+s CL.w���rq� <br /> i <br />� NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACE�".'AYS, MC OR AC CABI.E. <br /> i <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 31�;5 <br /> 1 here6y certily Ihaf I have read and examined this application and know Ihe same to be frue and <br /> correct. All provisions olla�vs and ordinances moveming this type ol work wHl be completed <br /> whether specilied herein or noL The granfing ti/a pemut does not presume to give authonty fe <br /> violafe nr cancel the provisions c!any uther state a lecal law regulafing construc6on or the <br /> per(ormance o/consfruc6cn. That 1 am aulhorizeo'bp Ihe owner o/Ihis property to peAorm fhe <br /> work lor which application is made and 1�omplp�vifh ;he State Confractors Law 18.27 RCW ano <br /> 296.200 N/AC. <br /> � ) <br /> %�.z�;����., ---- 9 ��- os <br /> % Signalwe �ale <br /> ,EOSos- /7Z <br />