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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES (' `7�s <br /> 3200 CEDAR STREET, EVEREIT, WA 98201 '7 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org ��So q--635 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> (25U � <br /> i� 3ni��r�.��-/ <br /> PROJECT AODRESS <br /> �:1,9v�,� a �cr�i9 f r2 ,.-�-r��f�1'�S �d,��/ho«� i�r 94Ss � �/ <br /> Owner A7ailAddress Ciry Stale2ip Phone <br /> Tenanl Mail Address Cily Slate/Zip Phone <br /> pcunJF_ ,L <br /> Eleclrical Conlraclor Mail Address Cily State2ip Phone <br /> Stale License Number Conlract Price of Work <br /> Proposed Use of Building Contact Pcrson (Plan Review) <br /> Description of Work to Be Done: XF -i.� ii2E ' K L',�tu✓,= ���rl r� � ;u I; n .F�JO [y ���. <br /> �/T /Jr�) �e ic (�,�o� 1T.JC� � �H�l�� /�a,�� � iJ ��A<.I �1`i v�,�� <br /> `�� �-��� �F. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ,_ <br /> .� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certdy fhaf I have read and examined this applicafion and kno�v fhe same!o be frue and <br /> correct All provisions olla�vs anAordinances governin�fhis(ype ol�vork�ti�ill be wmplefed <br /> whefher specdied herein or noL The c�ranfing oI a pernut does not presume fo give authority!o <br /> violate or cancel the provisions ol any ofher stafe or local la�v regu/atin�construction or the <br /> perfonnance ol consin�cfion. Thaf 1 am aufhorized by fhe owner ol this properiy fo pe�lomi the <br /> �vork for which appficafion is made and 1 cornpty with(he Sfate Contractors La�v 78.27 RCW and <br /> 296.200 WAC. <br /> i� , , <br /> f' /. /_, � ��/�/_. <br /> ��.;�,_ � .� .:� ��,�, ,_ <br /> Sl�naWrc ' Dale <br /> �D �� <br />