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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-BB57—www.evcrettwa.org C��� Q� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 5_�_ ' <br /> I �0 I aroa I c�.a � <br /> PROJECTADDRESS <br /> Ovmer MailAtldrese Ctry SlateIDp Phonc <br /> T�n I'S �Ct C� ' G�i'A(7�Q�C.4/a V �.VCf'Clr� �^ /���2ip l�J'O�7 0 on,J /� <br /> Irc;n+u Elcc��c, Tmc �38�v5 ��er �d Qow uJA 9$�� 360•�5�•r3:a <br /> EletlricalConlrado� MalA6�toss City SlaleRip Phone <br /> n O� <br /> 1'oin� r—�r /v� J� g1`�15 � <br /> Sla+.n�Imnsc Number Contrad Pdco of Work <br /> Proposed Uso of Building Contacl Person (Plan Revi:w) <br /> Description oi Woric to Be Done: /� C'v S/ � G// G �/ 7 4 � � 1/!S :�t �� <br /> . <br /> �O d o �o C G1 G G o n f/� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � , 1 Ct�j <br /> ��_ � <br /> t <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby certily that I have read and examinedlhis opplication and know the same to be trve and ��3D5- 03 � <br /> correcf. All provisions o/laws and ordin2nces govommg Ihis typa ol work will be completed <br /> wbRther speciled horein or nol. The granfing ol a ponnd Uoes not prosume fo give euthonty to <br /> violafo or cancel fhe provisions o/eny dher sfate or locallaw rogu/ating consfruction or the . <br /> perloimance o/consfruction. Tha(1 am autAonred 6y Iho owner ol this property fo podorm fho <br /> work lor wbich applic ion is mede and I compfy wilh fhe State Contractors Law 18.27 RCW and . <br /> 296.200 W%+C, <br /> ��-- s��G�/3 <br /> Signaturo Dale �' <br />