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EL�CTRICAL PER���iT "�PPLICATION <br /> CITY O� EVERETT PERMIT SERVIGES s ,6/a <br /> 3200 CEUAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org C/Ob S'"b� 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARD3 ARE NOT ACCEPTED <br /> l2 So2 I 6}�,q,,� 5 � <br /> PROJECT ADDRESS <br /> 3a�.�n�G.t'k.,�..� 1Z56Z �b�r'�J4va-S� �v�,�s�' �w�4 Zc6 �:�g/��t2� <br /> O��mer Mail Address City State/Zip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> �(25"`2�t o- <br /> �C'ss7'a� F1s�'�Jc �� 8,23d .,4-da.•,..•s �-Ve ��' �� `187�3 �630 <br /> Electrical Conlraclor Mail Address City State/Zip Phone <br /> P6ZCs1'C r ��3 ct-i <br /> Slate License Number Contract Price of Work <br /> s. r, v_ -r��,..� �6-5q�5 - ti3 �Z <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> D�scription of Work to Be Done: ZOC�/3 �4Y�s-�1 1V_.(��r-CA_�-� Cl'e-��.�3V '� _ <br /> _�c� t�.P �- Z C-<<c�•,�tS <br />' NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I� (� n 7 <br /> 1 hereby certi(y that I have read and exanuned this application and kno�v fhe same lo be true and l�I�"� — `� I ( <br /> correcL All provisions o(/aws and ordinances�oveming fhis type o/wurk�vill be cornplefed <br /> whether specified he�ein or not The granting ol a penni(docs not presume fo give authority to <br /> ✓iol�te or cancel fhe�rovisions oI any other state or lucal law regulafing construc6on or Ihe <br /> performance olconsfruction. That I am authorized Uy the o�vner o/this property to peAonn the <br /> �vork lor which application is made and 1 comply with fhe Slate Con(ractors Law 18.27 RCW and <br /> 296.2C0 WAC. <br /> —Z...,.,. '��- � -6 -C c� <br /> Si9nature Date <br /> I <br />