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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—w�wv.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> INIS c_NESTnur <br /> PROJECT ADDRESS <br /> I-�hA�K �.�'-�S <br /> Ownef Mall Address Ciry SUte/7Jp Phone <br /> Tenant Mall ACdrees Clty Slate/ZI� Phone <br /> yL5 ;o�' S75� <br /> 4,r,r� ��" E�.c�G�17'�i� 62.�3 '��sr S1— tic,, S�rA�•su�� c.�A �`5 Z`� 2 <br /> Elecldcal Contraclor Mail Addreee Ciry State2lp Phone <br /> �IMM I�� I �J00 ��-Z y rj6J <br /> State License Number Contract Price ot Work <br /> �` f I�' <br /> Propased Use of Building Contaat Pereon (Plan Revlew) <br /> DescriptianofWorkloBeDone: �-J ��M� SCr���--C �.11 � �1��+� �rr <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 7AX CODE IS 3705 <br /> I hereby certily that I heve read and exemined this applicatlon and know the same fo be true and <br /> conecf. All provisions o/laws and ordinances govaminq this type ol work will be completed <br /> whether specAied herein or not The grenting al a permd does notp resume to give eufhonty to <br /> vlolate or cancel the provislons of any other state or local law reguleting consfruction or fhe <br /> peAormance ol construchon. 7'hat I am authonzed by the owner o/th�s property to pedorm the <br /> work lor which applicahon is made and 1 comply wifh fhe State Contractors Law 18.27 RCW end <br /> 296.200 WAC. <br /> �. � --- Z� Z� O S <br /> Signature Date <br /> �C) S ?� � ��� <br />