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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRtET, 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 />� �� �� 4�-s�� - <br />PROJECTADDRESS <br />`��5 (ti{�ti�.t-�,� y <br />Owner <br />Mail AAdress <br />�S1 SLSI L I.t.�N{iL( � <br />cay <br />% �-�� � �� <br />CII D �%-0 �% <br />��`'3a� <br />SlatelZi Pho�e <br />�r�r- � yq� �z--y� <br />5 /�-w�t� <br />TOnanl I�IailAdJiess Ci1y SlalelZip Phone <br />� tw��'h.r2tc(h�l' rJDo�� (,QC�F— i�.-� �.�� �'IE%tMortic^ �� �S L <br />FlectriC2l Centractor Mail AAdress City State/Lp L/� r- �.�S.Pk�P„�� <br />/1 <br />C�r�r�cr--�y2W ��� � <br />Stale License Number <br />Praposed Use of Building <br />� ����� `� <br />Conlract Price of Work <br />Contad Person (Plan Re•+iew) <br />Description of UJork to Ba Dona: <br />CZ) (-IvN� sp�rT Sys��g <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 her�by certilu Ihat 1 have read and examined this application and know the same to be tme and <br />con�ect. All piovisions o( laws and ordinances guveming this type o( work wdl 6e, complefed <br />whr.11ie� specified heiein or noL The yianGny o(a pemu! does not presunie (o yive aufhouty lo <br />violafe or cancel the �rovisions ol any other sfate or local law r;gulating construcfion or tbe <br />pe.�lo�nance of constructioa That I arn authorized by the owner o/ this property to pedorm fhe � <br />won: (or whicli app6cation rs made and 1 compty wrth the Staie Conlracfors Law 78.27 RCW and � <br />2S 6.200 W AC. <br />?�19 ��/l7% �a <br />