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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 <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> -'724 .'LL� nw4v AV'L <br /> PRWECT ADDRE55 <br /> �`"�'�-iT C.4TtNA-1 Lc �i$:n_ <br /> Ownef MeilAddiese Cily Stale2lp Phone <br /> S"il�,'�i <br /> Tenant Mall Addtesa <br /> City Slate/7Jp Phone <br /> �'�i�s¢.zti�Z (%�fLr d� `1L'ct,�i11Y A-l.C. 17 -l'7 Q �11i1 A�,,, N� A2�in.� i��r�. i.11� ��5223 <br /> EleqncalContrador MailAddrose ���y 5���.P �o� <br /> 42S Zi{�l ry�iS <br /> �nn21 f=sy31 t+�c 1 zl � `�= <br /> State License Number Conlract Price of Work <br /> �'�t=f- �.-ssnrzp <br /> Proposed Use of Buitding Contad Person (Plan Rev'iew) <br /> Descriplion of Work la Be Done: i���p 3 Sn.,,ic., ��c�-���� � � ��C� .�•� }�vM <br /> �✓'u�Y--S <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> '� <br /> � � <br /> CITY OF EVERETT LOCAL SALES TAJC CODE IS 3106 <br /> /hore6y ceAily fhat I have read and examined fhis applicalion and know the same fo be(ruo and <br /> conect. All provisions ol laws and ordinancos goveming this rype of work will be completod <br /> whethorspoci(od Irorein ornot. The granfinq ola permd dces nof presume fo givo aufhority to <br /> violafa orcancol fhe provisions aI any otherstafe or locallaw regulafing pnnstruction or fhe , <br /> porformance of construc(ion. That 1 am aufhonzed 6y fbe owner o�Ih�s property lo podorm fho '� <br /> work lor whi�h applicafion is made and l comply wifh fho Stafa Contrac(ors Law 1827 RCW and ' � <br /> 29ti.200 WAC. �� �� <br /> i •/, <br /> - '�%��' �� �►� � 1 ,, <br /> Signalure Dato <br />