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—' � ; � y� �- �✓r� � � ,o� <br />ELECTRIGAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �_� �� <br />3200 rEDAR STREET, EVERETT, WA 98201 <br />425-257-8310 - FAX 425-257-8857 — www.everettwa.org CIOD 6—U�� <br />APPI_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECTADDRESS <br />5�,�/, <br />Owner <br />Tenanl <br />��W/1e� <br />Electrical Conlractor <br />Slate Licenso Number <br />Propased Use of Building <br />� <br />l�_ �cu �L l s <br />, <br />-v��r �/ <br />ail Address <br />Mail Address <br />Mail Address <br />ve rz7`/ `3 � �- v � <br />� v<r� {� <br />Ciry <br />City <br />City <br />Slale2ip <br />Slato/Zip <br />Slale/Zip <br />Contracl Price of VJork <br />y�s-3F�� = <br />Phone <br />Phone <br />Phone <br />Contacl Person (Plan Rovion�) <br />Description of Work l0 6o Dono: �'I C� �G C�� �"u� // �� 5� G� L� n ��¢ e�i C�� U;�s,� i�� � <br />SC /hr�/ W , �l I`z ��h1o✓ C = �'Cre �'e�`✓� ��`� � t , -Soan � S�r c <br />��od���� �'o.,�t�u;� ,�. .:Icor ���.��� k/rl� �� '�vve �l �.,:n re-ihs�,�� <br />� <br />NOTE: WIR�^!G IN NON-DWELLINGS IS REQUIRED TO <br />BE iN RAJEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />! hereby certily fhat I havo read ond ernmined this applicefion and know the same to be true and <br />correct. All provisiais o(laws and oin�nances governing fhis type of wcrk will bo completed <br />whether specified herein or noL The �rantrng o/ a permd does not presumo fo give authonty fo <br />violate or cancel the provisions o( any olher state orlocol law regulating con�tn�ctien orthe <br />performance of construcfion. That 1 arn authonzed by fhe owner o/ this propeRy te peAorm fhe <br />work lor which applicafion is mado and / comply with (he Sfafe Confractors Law 18.27 RCW and <br />29G.200 WAC. <br />�-'����..;�rl � �' ����1�� �" ��7- /� <br />