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ELECTRICAL PERIpJIIT APF'LICA►TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3_�j /� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> �IZD 2-1 3-� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i 2go(� � ��'' Av� Se <br /> PROJECT ADDRESS <br /> f ro��ic�..nc.'e� I?$00 (Q�h /�UE S� �y�.fGt1' I,J� QS'i20SC <br /> OWner Mail Address Ciry Slate/Zip Phone <br /> �� \\ <br /> Tenant Mail Addross City Stale/Zip Phone <br /> a�o c93 <br /> \{ � i � Sian zcoo ntE Ane�.re�•++ ��� L�N(,ouv�r W14 4AGL1 i17?3 <br /> EleCtncal COnlfaCtor Mail Address City Slale/Zip Pnone <br /> VaAlC�aS(.1�.71_�J — —q��(� <br /> State License Number Contrect Price of Work <br /> /�c.c�;c.�l .Q � Sto�' n�► <br /> Proposed Use of Building Contact Person (Plan Review) <br /> \ ' ' onu►nen-t 5;an5 <br /> Description ot Work to Be Done: �1��,�J,(1M 1►1t.l.t <br /> \ � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. 5O� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y cedily lhat 1 have read and examined this applicafion and know fhe same fo be true and <br /> correct. �II provisions ollaws and ordinances governing tlus type o/work will6e completed � I Z/�,� � I Z� <br /> whether speci6ed herein or noL The granfing oI a pemut does not resume to give aufhonty to lJ <br /> violate or cance/Ihe provisions ol any ofh�r state or local law reguPting consWcbon o�Ihe <br /> pedormance o(constiuc6on. That 1 am aufhonzod by fhe owner o/this properly(o peAorm the <br /> work lor�vhich applica(ion is made and 1 comp/y with fhe State Contractors Law 1827 RCW and <br /> 296.200 WAC. <br /> � , / ____ . Z/15 ZO IZ <br /> / Sig ture Date <br />