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( <br /> ELECT�ICAL PERMI�' APPLICATION <br /> CITY OF EVERETT PERMiT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �J/�u/�Z <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> �i�3—o$6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> y� � z a���. 1��..h �Z— <br /> , <br /> PROJECT ADDRESS <br /> m ; /� R� kT � ^,- <br /> z Q��w � ,2 <br /> � �9 - v.�z � <br /> Owner Mail Addresa City SWte/Zlp Phone <br /> S� � '�2s�- 7�d=sy� <br /> Tenanl Mail Addrese City StateZp Phono <br /> % v< r -'r... �/r.�.,( �Gc /6 f J�+ 8/S% F'.! i✓£ �/'eit...•c w A 7f�'�J' <br /> � Electrical nUador MallAddress Cily SWte2�p Y��"jriS��cy�hone <br /> �. � ,LD� a� <br /> State Licens umber Contract Price of Work <br /> Proposed Use of Bui d g Contac:Person (Plan Review) <br /> DescripUon o(Work to Oo Dono: .P f/ /�'T �` - ��B�vSs-/=l—� <br /> �— � <br /> � .[ � 'U <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 3105 �'(� <br /> 1 hereby ce.7ify thaf 1 havo read and exam(ned[his applicafion and know fhe same fo be true and ��2��'"�'�"� <br /> correct. All provlsions o(/aws and orrJinances govomfng this type of work will bo completed <br /> whether specified herein or not The granfing ol a pormd does nof rosume to givo aulhonty fo <br /> viola(e orcancel fho provisions of any ofher stafe orlocallaw reguPting construcfion orthe <br /> peHomiance o/conslrucfion. Thaf 1 am au(honzed by the owner ol this property to pedortn fhe <br /> work lor which appllcation!s made and 1 comply with tho Slafe Con(racfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,.�—�_ ���3�!- <br /> SignaWre ate <br />