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� <br />� <br />ELECTRICAL PERMIT �►PPLICATIOfV <br />CITY OF EVE�ETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� =�,�oti3 � Ti-1 D � �J <br />PROJECT ADDRESS <br />�R�ELr-�Nr� <br />OWnef Mail Address <br />Tenant <br />:` <br />Mail Address <br />CoNraclof Mail Address <br />`��rnr���[1 �Do�C.� <br />State License Number <br />��� <br />Proposed Use o( Building <br />Ciry <br />City <br />S <br />City <br />State/Zip <br />Stale/Zip <br />'^11) r"1<� L�j� <br />Slate/Zip <br />S Jc �! <br />Conlract Price o( Work <br />Conlact Person (Plan Review) <br />Description of Work lo Be Done: L,aJ /� rn� 1 SCt-U iC.� l.J 1� N Ci..� �i Q.. <br />NOTE: WIkING IN NON-DWELLINGS IS REQUIRED TO <br />B[ IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COD[ IS 3105 <br />I hereby ceR!ly ll�st I have read ard examined this application and know the same to be Vue and <br />correct. All provisiens olla�vs and ordinances c�overning this type ol work will be complefed <br />whether speci6ed hererii or nof The g�an(ing oI a pernuf does nof resume to give authonty lo <br />violate or cancel fhe pro��rsrcns oI any other state or local law reguPting construcGon or the <br />pedor,�iance oI consfruction. That I am authorized by the owner o( tlus property to perlonn the <br />work /or which applicafion is made and I compl}� �vifh the State Confraclors Law f 0,17 RCW and <br />�`�� rnr-��� 3� . � �� c� <br />SignaWre Dale <br />FEE <br />19fUTi[� <br />Phone <br />Phonc <br />� �� �' �j � �� � <br />