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�� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVE�L=TT PERMIT' SERVICES <br /> 3200 CFDAR STREET, EVERETT, WA 98201 3 �7._D� <br /> 425-257-8810 - �AX 425-257-8857— www.evere?twa.oig G a6o 3-os 6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��� / 3 �t-� Si <br /> PROJECT/�DDRESS <br /> /�o �r od �c'vc="12��� ���t�� G�� <br /> Owne� Mail Address Ci�y Stale/Zip Phone <br /> �o r7 Gf' L-U[�7� Es7? <br /> Tenant Mail AAAress Ciry StalefZip Phone <br /> � .f."�f'((,��� 5% L-Z�% c/U�J3 Srn�7l,Fi� E-"V�n �77 w,F. �7�i�J� <br /> Electrical Contraclor Mail Addmss Cdy StateiZia �'hone <br /> S �/� Iti '-�! l=--!U9�t C N <br /> Slate License Number Conlract Price of Werk <br /> Proposed Use of Buildinc� Conlact Person (Plan Review) <br /> Description of Work to Be Done: / /1(�%�-� << <2���' r-�-i�� %d1�'1�Rv '�✓�'O �r���//�'t�7 <br /> � • <br /> 1ZJ t�' "72✓�-r c. c.�;. <br /> NOTE: VVIRING IN NON-DWELIINGS IS REQUIRED TO FEE <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3i05 <br /> I hereby certify�hat I have read and examined this applicafion and know fhe same to be true and <br /> correcL All provisions o(laws and ordinances govemmg flus lype o/work will be cornpleled <br /> whether specdied herein or noL The granlin�ol a permd does not presume to give aufhonty to <br /> violate or cancel the provisions ol any other sfate or lor,al la�v regulating consfruc6on or the <br /> pe�fonnance o/consf�uc6on. Thaf 1 am aidhorized b}�fhe owner ol this property to peAonn the <br /> �vork Ior�vhich applicafion is made and I comply�vith the Sfale Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��'-�- � '� � �/�'� 6 <br /> /:,�� ,i�'� ; <br /> 3ignalur�—��f �` Da'le <br /> .��(�x�3-G>k <br />