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ELECTRICAL PERMIT APPLICATIOIV <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 /> - ��� �f� �� s� S� <br /> PROJECT ADDRESS <br /> 1�.T�. �1�� Ov�lNc�' — O �- <br /> Owner Mail Address City Stale/Zip Phone <br /> —�� <br /> Tenanl Mail Address Cily Slafe2ip Phene <br /> �RG ��< ��s�2 �?u�r.crL ,�{ � �02 Es�c-,���t cJ� 4'(�ze / <br /> Elec�rical Conlraclor Mail Address City Slate/Zip Phone <br /> ��nG�,=�� ��s a w �=���l� `� <br /> Sfato License Number ConV�ct Price o(Work <br /> �Sr2 ��J �lz�'�? a6 3 3 <br /> Proposed Uee of Building Contact Person (Plan Review) <br /> Descriplion cf Work lo�e Done: ����UC ���u� C�' �"�� G�n- ����— <br /> 7'�sr SysTc•rK � s�a-�-sy _ .�tis,-•r�� y U-rt. Gi c s /�r�c�-f. <br /> 4 ���� Gxsr� Gls�o Z � S,K�, A� �c. ��. �_ <br /> �xj2. �'-o�� �tc� �bo2 �?-� <br /> NOTE: WIF2ING IN NON-DWELLINGS IS REQUIR[D TU FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CkTY OF EVERFTT LOCAL SALES TAX CODE IS 3105 � <br /> I hereby certify(hat 1 have read and examined Ihis applicafion and kno�v the sarne to be h.ue and 1.���?�� �!�' � �� <br /> con�ecL All p,ovisions o(/a�vs and ordin;mces govcrnmg fhis type aI n�ork u�ill be comp/eted <br /> whefher specGed herein ornoL The�ranfing o(a pennd does not presurne fo give aufhority to <br /> viola(e or can�el!he provisions ol any ofher state or local la�v re�ulating consfruction or the <br /> perfonnance u(consfruction. That I am authorized by fhe owner o/fhis properiy fo peAorm fhe <br /> �vorlr/or�vhich applicafion is niade and I compfy with the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� ^\ <br /> —.A�� �'C��' 3�� � �� <br /> ic n'ly�+ --_ D te <br />