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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, NJA 98201 <br /> 425-257-8810 - FAX 425-25--3857 —wwvi.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��'��7 LLrANP el1 lL'2v =vUL� I�A, y���� <br /> PROJECT ADD ESS �� <br /> Owner Mail Address Ci1y Slate2ip Phone <br /> fi'PS `f 9/7 ,��-orev�, wa, ``u��� Lvv f/83a 3 <br /> Tenant MailAddress' � Cily SWte2ip Phone <br /> ;r� -:2�ar !;��. ��G,P�x _'s �P�o�� w�. v�o�.�-�z� (s�zs)sss-y�s� <br /> Electrical ContraClor Mail Address City State/Zip Phone <br /> '�h�1NaT :1f= 13 2 k�N ,�'`�Sdcao <br /> State License Number Conlracl Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion of Work to Be Done: �U/.C-L_ 7r�� <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> EiE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and exandned this application and know tbe same to be true and <br /> correcL All provisions ollaws and ordinances governing fhis type ol work will6e comp/efed <br /> whether speci6ed hemin or ncf. The granting of a pr,rnuf does not resume to give authonty to <br /> violate or cancel the provisions o/any othe,-s(ate or local law re�uPfing construction or the <br /> performance oI consfrucfion. That 1 am authorized by fhe owner o/Ihis property to perlorm fhe <br /> work lor�vhich application is made and 1 comply with fhe State Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> �if�- � <br /> ��-li -�'-�d � //�i,.�� �� f <br /> / Signalure Uaje� <br /> .Gl I I -G� 1 <br />