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ELECTRICAL PERMIT APPLICATIOIN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereriwa.org /a �- a 3 -/� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L�-�O/Z �/��J <br /> _; crZ-� 1�•TH N�"� '�; �'q ' <br /> PfROJECT ADDRESS <br /> � <br /> _s <br /> Owner MailAdpress Cily Slate2ip Phone <br /> .LAI�ESiGt t�J�,j��:::��c� li-;`2.5 i°�i H AJ� �.�, ���t � <br /> Tenant — 7•c� �V4irt.ii i�.n <br /> MailAtldress Ciry Slnte/Zip Phune <br /> ��,�����;_�-��,_f, a s�� <br /> ��- i4 L�� �7bu-� S•iT�� !�J` h" I��6�AbiC' 4 " A �•,�•23 ir i ��i I�i�{i <br /> Eledrical Cuniracto� Mail Atldress City Slale2ip Phone <br /> fz�n::.e. [i=S�i3ih,�. - cc. <br /> 1S � � <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contad Person (Plan Review) <br /> DescriplionofWorktoBeDone: r1iei: i>t �<< ;r. �7�,:,r�:.;�� ��.�i'�e:...��.�.;i�r). <br /> NO i E: VI/�RING IN NON-DWELLINGS IS REQUIRED TO FEC <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I homby cerfily Ihaf I have read nnd oxamined fhis applicafion and know(he same fo be true and <br /> corrtict. All provisions ol laws and ordinancros governmg Ihis rype o(work�yiil be complelod <br /> whethar spoc:(od herein or not Tho granfing oJ a permd does not resomo to give aufhonly fo <br /> violafo or concol fhe provisions ol any o(hor sfafa or local law reguPfing conshuclion or the <br /> pedormanco o(consfniction. That I am au(honzed by!he owner o(7his proporty fo poAorm!he <br /> work lor which application is made and 1 aomp/y wilh the Stafe Confrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> , �� ��-" <br /> - - � ,�� <br /> ,,. „ . ,. <br /> ;, �-- , � ► <br /> -` '" 1��'-% i�J <br /> SignaWrc Uale <br />