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ELECTRICA�L PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —v✓ww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ; i �` i���/%�) �/il1 . �.�/G(�Zli'�7 %�j� , 7 '% <br /> `> .SvL' I <br /> PROJECT ADDRESS � � <br /> _ �� <br /> �:lil ��%/''Si!/ �����3� %/�..0l10�/il� �_ii9k'S( � %�:l �/.Jf '� � <br /> Owner Ma�l Address Cily State2ip Phe�e <br /> I � <br /> � <br /> Tenant Mall Addrese City Slate2lp Phone <br /> //��//l/ �!= <br /> EleClricalContractor MailAddresa Cily State/Zip Phone <br /> �Lr <br /> `� �' �J�f� i� <br /> � <br /> Stato License Number Contracl P�ico of WorY, <br /> �qi!_��L ��J',/�� <br /> Prop srd Uso oi Building Contacl Person (Plan Review) <br /> Descnption of Wark to f3o Dono: _��y�( ��'C` �l,l�'�� l `{ �C b G G�'/��«/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I here6y certity fhat 1 havo read and exemined fhis applicalion and know the same tu be frue and <br /> comecL AB provisions ollaws and o�dinances goveming this typo ol work�rill be completed <br /> whether specified herein or noL The granfing ol a permd does nof xesume fo give authonfy to <br /> ��iolafeorcancelihe provisionsofanyofherstateorlocallawregu�atingconsfrucfionorthe <br /> perlomiance o/construcfion. That I am authonzed by the owner ol thls roperty fo perfomi fhe <br /> work lor which applica(ion is maee�nd 1 co with tho Sfafe ContracPrs Law 18.27 RCW and <br /> 296.200 WAC. ) <br /> ' � � <br /> � ��----, �1�� <br /> Signatu '' Dale �/ <br /> ,;Nt�� <br /> i � <br />