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ELECT'RICAL PERMIT APPL.ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettvea.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _=zQ�y��/i� #/o g' i <br /> PROJECT ADDRESS <br /> �n.�'-� �u't"1' �tJS7v1��-�c��/ _ <br /> Owner Mail Address Ciry SWte/Zip Phon� <br /> �=�-r .��� <br /> Tenant Mail Addiess City St�fc-.2�p i�i,one <br /> � a�-9�� �si <br /> ��i�s_l7,�i9(�v1 FJH i f� e /tZ'D}�.�>�.�? �D ���'���/'J� �i✓ (i1Jf� �� <br /> Eleclrical Contractor Mail Address Ciry State/7ip/ Phone <br /> - � Sf�6Z � �?� �Q <br /> S ate License Number Contrect Price o(Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion of Wark lo Be Uone: .J-iUctH 11�U U'C��7�3(r ���QM <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVLRETT LOCAL SALES T.4X CODE IS 3105 <br /> I here6y cenily that 1 have read and exan:+ned Oiis applica!ion and know fhe same to be trur, and <br /> correcf. All provisions ollaws and ordinan:es yovenun�tn�s fype o/�sork will be complefed <br /> whefher speaGed herein or noL The grantiny n/a pemut does not presume to give authority to <br /> violafe or cancel the provisions ol any other st,�to or local law regulating consfruction or ihe <br /> pedormance W ca stn�ction. That 1 am aufhorized by the o�vner e(this prcperty fo peAorm the <br /> work lor wAich ap icafion is made and comply�vith the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. � � <br /> �" -- <br /> � �� % a ,� <br /> , Signature U <br /> / <br /> .'=i> 1(.�> C(U <br />