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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857— www.everettwa.org /� ✓ .� 3_0 5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM E- OS/l /02 S <br /> � ' , ���e �j <br /> _—J ' C� c� �c��1� ��e ��� ��o!/�G��/ ��G <br /> PROJECTADDRESS (�Ffj�� ��J,C�JAL�}���)��'G— ���� <br /> !�,d�� ,E�vc�i�iV� � � 6��/w � c����r,�� ,U�� 9�5.32 <br /> Own r Mail Address City State/Zip Phone <br /> �f�� �/✓G�f✓i� � C� L�� /G� e C/-�r/�hL� , l.�/1 9' �-SSZ <br /> T2nant Mail Ad ress City State/Zip Phone <br /> Electrical Conlrector Mail Adtlress City State2ip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ���'ly Pr-'��/ S'`� vYC F �/l7 ��1'�3f'�J,�,4 L G'f' <br /> --� <br /> NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO FEE <br /> EE IN RACEWAYS. MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I herehy ceRi(y that 1 have read and examined this applica:ion and know the same to be true and <br /> �onecc All provisions o(laws and ordinances goveming this type of work will be completed <br /> whether specified herein or not. 7he granting o/a permd does nof �esume to give authonty to <br /> violafe or cancel the provisions o�any othe��iate or local law reguPting coostruction or the <br /> peAormance cf construction. That 1 am authorized by the owner of this property tu perform the <br /> work for which applicaticn rs made and I comply wi!h the State Contractors Law 18.27 RCW and <br /> 296.200 WAC <br /> �i' � „� //- � 3- G-�" <br /> � a�gnature Dale <br /> / <br /> .r— <br /> � ��� — �� J <br />