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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �8_ob <br /> 3200 CEDAR STREET, EVERETT, WA 98201 8 ` <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org L o6 pg-0�8 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3003 � . c�.3;„ o R,�. h�o - �s6 <br /> PROJECT ADDRESS <br /> 4 � C t„� � . 11- ..�A G9�o•-r <br /> Owner MailAtldress City Slete/Zip Phone <br /> 5 <br /> Tenant Mau Atldress Clly State/Zip Pnone <br /> y-15' <br /> ��� ,. < �, �i- '�� �4. ,,ol ��i �s Re..a, �.JA 9�oe�s7 a�.� aas <br /> Electrical Contractor hteii naaress Gry s�e�erZip Phone <br /> COIJVtT� 995U �1 a1R, oi7 . on <br /> State License Number Contract Price ol Work <br /> Proposed Use ol 0uildmg Contact Person (Plan fteview) <br /> , <br /> Descnption ol Work lo Be Dona�. j��rl- �1 n���. -S'�tr��t i n'�'v ALL e<< CO�� r o � Oa�� e S. <br /> _ ,� 3 ��oor5 <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 C06E IS 9705 <br /> 1 horeby cortily thnl I havo road and examined this opplicntion and know U�e samo to be truo a.ad <br /> corioct All p�ovisions ollaws and ordinances govermng this type of work will 6e complefed <br /> wheflrer spocilied hereir oi not The granhng ol a pormd doos notp resume fo give aufhonty fo <br /> v�olafo or cancol tRo provisions o!eny other stafe or local law regu/nfmg construcfion or the <br /> poAonnanca o/wnslruchon Thaf I am aufhonzed by the owner ol fhis propeRy to poAorm fhe <br /> worklor which apphcafion is made end 1 comply with fhe Stato Conhaclors Law iB27 RCW and <br /> 296 200 WAC. <br /> Ll '��,,,�d 4r� /�� o!_ <br /> Sgnatwe � Dale <br /> � <br /> t-C�O� " (� 1��,7 <br />