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ELECTRlCAL P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �p — /�(�� <br /> 425-257-8810 - FAX 425-257-8857 —wv✓w.everettwa.org <br /> ��� �io-o65 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���;i�;(., i 5 � ,� � ���� �,a� � � <br /> PROJECT ADDRESS <br /> �`�c,c� <<�r,^n,�rt� Cvti��r - /r'A�z�s t��/% <�G�/s l �s lS <br /> Owner Mail Address Cily State/Zip Phone <br /> Tenanl Mail Address Cily StatelZip Phonc <br /> C �' �'IU(' � � �c`ci/7/C' ��/" !70' 1S�Z Z /�"�IFRYSI'�/%` llJ/�� �l82 `fQ ��rs)Q?o �r3,/�'' <br /> Elecl�ical Conlraclor Mail Address City Slate�Lip Phnne <br /> i <br /> � c� ru i G C"�� �l L=/l.�I; <br /> State License Number Conlract Price of Work <br /> `�� ir' Cr�e �/1 ������ r� <br /> Proposed Use of Building Contact Person (Plan Revie�.v) I, <br /> fl,�� W ' <br /> IS.� 7 tG, j ?j 'T sT�1r� ���a � �.� 5� ��- C� <br /> C�:scription of�A'ork lo Be Done: �^ <br />� NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />` BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAi( CODE IS 3105 <br /> I hereby ceRily that I have read and examined fhis applicafion and know the same to be true and <br /> correcf. Al!provisions ol laws and ardinances governing this type o/�vork will be compleled <br /> whether specilied herein or noL The 9rant�n�ol a pernut does not presume to give authority to <br /> violate or cancel the provisions oI any other state or local law re�ulatinq consfruchor or the <br /> petformance o/conslrucfion. That 1 am aulhorized by fhe o�vner o(th .property to perforrn the <br /> �vork/or which applicafion is made and/compty�vifh the Sfate Contr�ctors La�v 18.27 RCW ar,d <br /> 296.200 WAC. <br /> � ��%..- - -_ .__ ) r. <br /> -- ' � .�L"�V�� -� . �- I�/ /�I� 7cC- P <br /> _ SignaWre a�e <br /> � vaiu-v�5 <br /> �� <br />