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I <br /> ELECTRICAL PERNIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR ^TREET, EVERETT, WA 98201 9 3/a3/ <br /> 425-257-8810 - FAX 425-257-8857-www.everetlwa.or �a <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Eiao3—I�z. <br /> 58 � y c�� R� <br /> PROJECT ADURESS <br /> s v�- T�.�N� �v� is ,�V.t i�� 7T 1�V�4 98��3 <br /> p�y�e� Mall Addresa Clty SlaldZip Phone <br /> yz.� - ��3 - ���5 <br /> Tenen� Mall Address City Slate/Zlp Phone <br /> o � � � <br /> Eleclrical Conlraclor Mall Addresa Clty Slate/Zip Phone <br /> E'ate License Numbar Contract Prlce of Work <br /> ��r- r� <br /> Proposod Use of BuIldlnp Conlad Person (Plen Revlew) <br /> DescdpUon of Work lo Bo Done: �I�����r � — <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /� �7 <br /> l l�ereby certlly that I heve read end exemined thfs applicallon ond know fhe same fo be true and l.���`� ' I �� <br /> correct. All provlslons ollaws end ordinences goveming this type ol work w7116e completed <br /> whefher specllied hereln or nof. The granNng ol a permit does nof presume fo glve aufhorify to <br /> vfo/ete or cencel tfie provlslons ol any ofl�er stafe or local law ragu/etlng cansfnrcflon or fhe <br /> peAormance ol conslrucffon. Thaf 1 em eufhorized by fhe owner ol fhls property to perfoim fhe <br /> work/or whlch appllcatlon ls made end 1 comply wRh fhe Sfafe Contrecfors I.ew 18.27 RCW end <br /> 296.200 WAC. <br /> ���'j� �0�02.3--/,�/ <br /> Slgnalure Date <br />