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ELECTI�ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SE�2VICES <br /> 3200 CEDAR STREE i, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereitwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �7l7 2s � �. ,1 ,c �,,/ <br /> PROJECT ADDRESS <br /> � �" �d�tJ.=:oJ s'7� 7 7 '"r- /IJ�; w �U�IL�=T vA- <br /> Owne� Mail Address Cily Stale/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> yy�. rvv•3s�t <br />� �dwh�cfiwi�(�c�X-- ���'zr��Z lNzbrt✓�a �me �3ar S.�ol�aM�cG. � a 1PcYo �,��:+ <br /> El=ctncal Conlraclor Mail Address Ciry State/Zip Phone <br /> SGNw�rsc- I�- y&o ��% fi ;�"'. °� _ _ <br /> Slate License Number Contract Price of Wor!. <br /> � SE I J SGtca�ti.fGwt u�� �.ti/�}� <br /> �J�l� �i���.�6� ri1,r Urt.,_1,.,-,�� 1 <br /> Proposed Use of Buildinc� ' Conlacl Person (Plan Review) <br /> Description of Work to Be Done: i3 pD ' " �:"� c'`h'�"`�" rvi� /}'2 �°'"��""�'�`S vi,,i E" <br />� NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> g <br /> u <br />��' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fliat 1 have read and examined this application and know fhe same to be frue and <br /> conect. �lll piov�sions o(la�vs and ordinances governin�this type oI work will be complefed <br /> whether speci6ed herein or not The granting ol a pennd does not�resume fo give aufhority to <br /> violate or cancel Ihe provisions o/any other sfate or Incal law regu afing construcbon or fhe <br /> performancr,ol consVuclion. That 1 am authorized by Ihe owner o/this property fo peAorm the <br /> woik lor which applicafion is rnade and I compty with fhe Sfale Contractors Law 13.27 RCW and <br /> 296200 WAC. <br /> i" � <br /> �`^('! ��,;,/,;Gr'�s�' i?//S r�,�� <br /> Signalure / Date <br /> �/Z -//.� <br />