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ELEC1'RICAL PERMIT APPLICATION <br /> CiTY OF EVERETT PERMIT SERVf�ES <br /> 32�0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org / 2 -I s�-�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � U S� 2 _(�� <br /> I(��LS I � fL�� �� S� �(�1� �J�1v°� �./ <br /> PROJECT ADDRESS <br /> ���'� 1i,{ CN � �voZS f ;-��.� � ;�L (=11�✓'c-t=11 , i.�� ��'�Df� <br /> OwnB� Mail Address f Cily � S�ale2ip Phone <br /> ��U/1'E <br /> Tenanl tdail P.ddress Cily StatelZip Phone <br /> �Jz.s -SS�� -17�� <br /> ,�1/�r�s.� C.ql�;C c, ;,1�J�45 I f3�7 1 �Z.��r U� �CU,��/�,1L ,w�i `�����S' <br /> Eleclrical Corlrac;or Mail Address � Ciry '� Phcne I <br /> ,�iCi�lJd ��.� C�D7U✓1 � � 5 /Sc�C� <br /> State l.icense Number Conlract Piice of Work <br /> ��✓�� �-' U�'�� � 1�2/{` l�"- 1'r ��I�'c-� <br /> Proposed Use o(Buildinc� Contacl Person (Plan Review) <br /> y��= �rL�-�� z�,� <br /> Descriptiono(VJorkloGeDone:/ �V �V �/O�� �� ��-4�r"C �,�� �� <br /> NOTE: WIRING IN NON-DINELLINGS IS REQUIRED TO FEt <br /> BE IN RACFWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this applir.ation and know Ihe same to be true and <br /> correct. All provisions ollaws and ordinances governmg this type of work will be complete�i <br /> whethc-r specdied herein or noL The granting oI a pennd does nof resume io y�ve authonry to <br /> violate or cance/the previsions o!any other state or local la�v reguP�ing construction or the <br /> perfonnance o/consU+iction. That 1 arn aufhorized b}�the o�vner o/fhis propeRy to perlorrn the <br /> a�ork lur�vhich applicafion is made and I comply�vifh the Sfate Contraciors La�v 18.27 RCW and <br /> 239.200 WAC. „ : <br /> �' � / <br /> /��/i r �,f�� � <br /> ;% i�/��'��_. �� z -/ J.�� V <br /> ��4 SignaWre " � Date � �\ <br /> ��� �U <br />