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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �/ <br /> 3200 CEDAR STREET, EVERETf, WA 98201 �Y����� <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org �!l/��a� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> o? D7 � �� ,� <br /> PROJECT ADDRES <br /> J//��U/'.�i�v_s.�'/G`�i��'� 46 �l�<ti�fi'/G,f C(/�-���F4 9�=�/ yas'��S���O <br /> Owner Mail Address � Clty StateRip Phone <br /> /l��l�i' � 70 7 L�>�� .��,� 5J'�l2�� C%�� �1 R�.al� �s��sd�zd�% <br /> Tenanl Mail ddress Cily Slata2lp Phone <br /> �,l �h.� �c,f�i.�,�C �� ��' ,�Is S1��i�yi,R't r,vLG ��i�i/ �6i Fald <br /> Electrical ConUaclor � Mail Address Ciry State2ip Phona <br /> ��ao�py�ie � �`�o� �00 <br /> State License Number Contrac!Price af Work <br /> � <br /> �Gl.uq�._O�fi{i� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> DescripUon of Waric lo Bo Done: G+�� �' — ���' r'���"Q �'w�� ����'� <br /> � <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 3705 <br /> 1 here6y certify Ihaf I havo read end examined fhis application and know the same to be true end <br /> conpct. All provlsions of laws and ordlnances goveming thls type o(work will6e completed <br /> whether specified herain or r�ot The granfing ol a permit does nof presume to give authonry to <br /> viola(eorcancelthe provlslonso/anyotherstxteorlocallawregulatingconstructionorfhe <br /> performpnce ol cons[ruction. That!am authorized by the owner o/fhls property to perform the <br /> work lor which application!s mado and 1 compty with tho Sfate Confracfors Law 18.27 RCW and ,/� �D ` / \� <br /> 29G.200 WAC. d <br /> Signature Date <br /> I — <br />