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ELECTRICAL PERIV�IT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org C( � 6 �07 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �07 b U-O�{�� <br /> //�//i - i`i��' F9v��� sc <br /> PROJECT ADDRESS <br /> �;;:�i �_�� �j�����i�i' Ct�Jf'7.�":, ;`;'" r 1 ��'� rT , � � ;� �, <br /> Owner Mail Address Ciry State/Zip Phone <br /> c7_ /�%i�'� .no - /���i9 ii�y /ti=" Sc' c1 �>�'� TT c �'�� `�S ?v4 �rvri <br /> Tenan� Mail Address City StatelZip Phone <br /> .� � - � � � �.i C �'?c. ��/(-. .` <br /> �.i':�i I � ��.''-' SC )�L�/(G. j (�-.1U '',��/��ci.( E-1,'L):c�T�"�t �i / lll (/.C:Z.;IL� (.L ( �u i -U <br /> [�eclrical Conlractor Mail Address Ciry Stale2ip Phone <br /> Y;��7 S�l S .� 1 `� �' i'�c . Sn �— <br /> Slate License Number Contracl Price of Work <br /> I 11 _ �., [� <br /> �l �}���. I �'•��lV/C `l•L J i l J /J��� � <br /> Proposed Use o(Duilding Conlacl Person (Plan Review) <br /> Descriplion o(Work lo De Done: _ � �� - I}l l � `- : C � I{�\r�;��=� �-c_1'r1-t � �J I S /'� �"i/ <br /> fl;�.�.1 �\ c� L �,e��-_ � <br />� NOTE: WIRING IN �!ON-DWLLLINGS IS REQUIRED TO FEE <br /> EiE IN RACEWAYS, MC OR AC CABLE. <br />� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this ap��lication and kno�v fhe sarne to be true and <br /> r,orrecf. All provisions o/la�vs and ordinances governm�fhis type ol�vork will be completed <br /> whether spealied herein or nof. The gnnting oI a perrrut does not �resinne to give authorrty to <br /> violate or cancel the provisions oi any other sfate orlocal law reyu�ating consVuchon or the <br /> perlormm�ce oI construchon. That 13m aufhorized by the o�rner of Ihis property fo perform fhe <br /> work(or whicA application is mad=and 1 comply with Ihe State Contractors Law I8.2i RCW and <br /> 296.200 W4C. <br /> �� � � �� �16u- `-��� <br /> r �� -�� _ � <br /> oi�naWre Date <br />