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Et��CTRICAL PERI�'"!T APPLICATION <br /> CITY OF EVERETT PE�2MIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982(?1 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �s ��; s'`� `�^.�.� sr -� c�� �� �- �,.....3-: ,�L. <br /> PROJECT ADDRESS � <br /> .2..;;� :�-,�.� C',�L <br /> Owne� Mail Address City StatelZip Phone <br /> Tenanl Mail Address Ciry Slale/Zip Phnr.e <br /> �ci arv... N,1�1 t_z.�� %C4't��{:.. �/�hSb G�-+aa�.i�!r� L'rv�L� J-Lt.G:.ii,-�cl, '-'� /�-'.'�i .�G..ci .)?j/. 7S"I z <br /> Eleclrical Conlraclo� Mail Address City Stale�Zip Phone <br /> ��'j,v�i,/ MF `!%��� <br /> State License Number Contracl Price ot Work <br /> � <br /> /i e i f c�:-cu k:v •. �"1�i L�. <br /> Proposed Use of 8uilding Cuntact Person (Plan Review) <br /> � <br /> Description o(Work to �e Done: •Z 4�.e�2r a,,,. 1 <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhaf 1 have read and examined fhis applicaficn and knav fhe same to be true anu <br /> cwrect. All provisions o/laws and ordinmices governm,q fhis type of work wil/be completed <br /> whefher specdieJ herein or nat The granting ol a perrn�t does nof resume fo give authonty to <br /> viola(e or cancel Ihe provisions ol any other sfafe or local law reguPting construchon or the <br /> pedormance o/construdion. Thal 1 am aufhorized by the o�vnei o/fhis property tn pedorm the <br /> tvorl�(or�vhich application is rnade mid 1 comply with Ihe State Contracto�s Law 1�.27 RCW and <br /> 29G.200 WAC. <br /> �� / <br /> i � LC�—. /, %, /`Tl��,, <br /> , SignaWre u Date <br /> �'o50 � - U1 / <br />