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� <br /> i <br /> ELECTRICAL PERIVIIT APPLICATION <br /> GITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> i `•? �� U� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C /�� <br /> ;O.�G %�- <br /> � �� ;:�"�'�i i il� �� ����' �� '—"' -- <br /> PROJECT ADDRESS <br /> �� G�:i(� �il�l lLa �CN>� - �r'ii�,.��'� r��� ; � �., �� -�(-. <br /> Ovdne� Mail Addrass Cily State!Zip Phone <br /> Tenant Mail Address City SlalefZip Phone <br /> �/'�S�J 7G1 -l�?�O <br /> � t !Ji l'(' 1 �.�c i I<iri ���C� iJ('�Y ��'22 IL4" -. ;�� ; �'� ��'� c�7� <br /> Electrical Conlractor Mail Address City Stale/Zip Phone <br /> < <��;r u c� c�i, �i i3 i3� -- <br /> State License Number Contracf Price of Work <br /> ���A,�J,' l `,� NI� I�tsle��� ti76 -- I <br /> Proposed Use of Building Contact Person (Plan Review) I, <br /> Descriplion of Work to Be Done: �C.�' �N i� .Jc-iZV t Cc ; � � `��i� 1 % �< <�� S�1 �� ' � � <br /> fdOTE: 1NIRING Ifv NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3?OS <br /> 1 he�eby certily that 1 have�ead and examined this applicafion and kno�v fhe same fo he Vue and <br /> r.onecL All provisions ollaws and oniinances govemmg this type ol work will be complefed <br /> �vhelher specdied herein or noL The granting ol a pemuf does not resurne lo give authority fo <br /> violate or cancel fhe provisions olany ofher stafe orlocal law reguPtiny construc6on or the <br /> peAormanr.e o(r,aisfruchon. Thaf!arn authorized by the owner ot fhis property to pe�form the <br /> �vork lor���hich applicalion.is made and 1 comply with the Stale Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �--� <br /> ,,'.,< _ _z�' - O�- 2�- � 8 <br /> . SignaWre Date r? <br /> , �I `� - /Cn.:Z <br />