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�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, �NA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />S%.Z�-/ D �0.��-VG�`/ � �cf-I`-1 '��', i���enn�md �re5+ � <br />PRUJECT ADDRESS <br />� L C.bvisi-r�t��4io� �n4B'� y5o� 2525 #3rnacl�c���Ev��c�3-1, WG. 9k2or y7�Z9a5sr5� <br />OWner tvlail Address City Slate2ip Phone <br />Tenanl <br />Afail Address <br />City <br />SfatelZip <br />Phone <br />�cax�(1e\1 �\e��r�U��nc,,_��w�is�,A,�i`1�,L11-•�evevis�W�q8258 �?�3�`l�00 <br />ElecUical Conlractor Mail Address Cily State2ip Phone <br />v�2���z�-�av�.� <br />State License Number <br />S�cz <br />Proposed Use o( Buildinp <br />Description ol V1brF: to He Done� ��.'��=_ <br />NOT�: WIRIfJG IN NON-DW�LLINGS IS RGQUIR[D TO <br />aE IN RACEW,4YS, ��1C OR AC CALiLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price o( Work <br />���� — �ZS 2�13 S4S� <br />Contact Person (Plan Revie�v) <br />1 heieby certily that 1 have read and examined this application and know the same to be tnie and <br />r,orrect All provisions ollmvs and ordinances goveming lhis type o( work wili be completed <br />whetherspeci6ed herein ornoL The granting o(a pernut does not presume fo give authonty to <br />violate or rancel Ihe provisions ol any other state orlocal la�v regulating consfruchon or Ihe <br />per(orr.wnce ol construcfion. That I am authorized Gy tlie owner o/ th�s property to perform the <br />wo�k /or which applicafion is made and 1 compl, �vifh the Sfate Contrar.fors Law 18.27 RCW and <br />296.200 WAC. <br />^\\ v�.��Qs.�` �. <br />Siynatwe <br />�>- \�1 , � b <br />FEE <br />r-����-ry3 <br />