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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 1�`�!�6/'� <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM <br /> C—I//2—O4G <br /> I 5 G 5 �o� �<.� I�.lo , <br /> , <br /> PROJECT ADDRESS <br /> U2S <br /> �IALc �ck )���r�cl ��2 �lfl� V� ���1�. � ve�e?�- vJ� q820� 2s�ai�3 <br /> Owner Mail Address City State2ip Phone <br /> Tenant Mait Address City State2lp Phone <br /> GW ��� <br /> Eledrical Conlraclor Mall Address City Slate2lp Phone <br /> Slate License Number Contract Price of Work <br /> �Z��-� �� <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Description oi Wotk lo Bo Done: �� �C �r � � ` \ ���''� �� � �� " ` �� ����UJ <br /> �c�r c't C�5- r l� � S 6 5 l�^ o''.sZ C�z�r�C 1 c��s O �� � 4 � �n 't` <br /> ,� � � � �1 � r5 + � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 I -7 / ' <br /> 1 hereby certify lhat 1 have read and examined this application and know fhe samo to be true and Cl � L' v'7 � <br /> correcf. All provislons o/laws and ordinances govem�n,q Giis type ol H�ork wll!be completed <br /> whefher specified herein or noL The granfing o/a permif does nof presume fo glve aufhonty fo <br /> violafeorcancelfho Provisionsolanyothersfafeorlocallawregulatlngconstructionorlhe <br /> performance o/construction. That 1 am authonzed by Ihe owner of fhls�roperty to pedorm fhe <br /> work lor H�hich application!s mado and 1 comply wifh fhe Stale Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> `? � � �✓ C/ v.�_.� ( Z � � � <br /> ��S gneture Date <br />