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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PEi2MIT SERVICES <br /> 3200 CEDAR STREET, EVERE'iT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACGEPTED FROM 8 AM TO 4 PM <br /> zll�f hAuE� �l ��� <br /> PROJECT ADDRESS <br /> E���N�� � '�� z��y �AX�R �vE,�� w� y25•.�-�D35 <br /> OWnef Ma6 Addresa City Stale2lp Phone <br /> Tenant Mall Addresa City State/Zip Phone <br /> Elecfrlcal ConUector Mall Addreae City SWte21p Phone <br /> Slate Llcense Number Conlrecl Prlce of Work <br /> s r-�, <br /> Proposed Use of Bulldhig Contacl Person (Plan f?evlew) <br /> Descripllon of Work lo Bo Done: U� I I�-�I! V� N�� sl�'G,l��'/�Ml L�R�ID�IU�=C . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, W1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat I hevo read and exemint�d fhls epplicafion end know fhe same fo be fnie and <br /> co�iect All provlslons ollaws and ordlnances goveming thls fype of woik wlll bo complefad <br /> whefher specified here/n or not. Tlie grenf(ng o/a penn�t does nofp resume to gfve ao•�ho�fy to <br /> vlolafo or cancel fhe provlslons ol any other sfa!9 or local law regulating consfructlon a� fhe <br /> peAormance o/constn�cNon. Thr.t I am euthorl:�3d by fhe owner o/fhis property fo perloim fhe <br /> work lor which appllcafior,!s mede and 1 compl�wlfl�fhe State Contrec(ors Law 18.27 RC4i�end <br /> 296.200 WAC. <br /> ��'��_ .<J z��i ' � io <br /> Signalure �ala i <br /> �j0� <br />