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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES og�7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 -�w�nv.evereltwa.org C D7D ��-D Gjs <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �53�'�/ ���8% .r1-J� <br /> PROJECT ADDRESS <br /> �i ICl E �%�� � <br /> Owner Mail Address City State/Zip Phone <br /> �,_' �_ <br /> Tenanl Mail Address City Slate2ip Phone <br /> �,v•�-C' ✓ �L f� /��/� � 7�J s � S� �-�� l�i�' l���t� <br /> [ledrical Contractor Mail Address City State/Dp Phone <br /> ,�= �%�'i'L'%�4 �- ���� L ��'-20.5"� 7S� <br /> Slale License Number _ n G Conlracl Price o(Work <br /> /% ��_�'Z L. <br /> J <br /> ����t h L�L`'�� <br /> Proposed Uso of B�ilding Contact Person (P�an Review) <br /> �, �� �- <br /> Description o`Work lo Be Done: �/� 1 /`���'L' � ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � J� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certily thaf 1 have read and examined this applicafion and know fhe same to be true and <br /> correcL All provisions ollaws anAordinances governing fhis type o!work will6e complefed <br /> whether spec�fied herein or not The granling ol a pem�d does nof pmsume to givr, autborif y fo <br /> ��iolafe or cancel Ihe provisions of any ofher sfafe or local law regulating construction or fhe <br /> peAormance oI construction. Thal 1 am authoriied 6y the owner o!ihis property to pe�form fhe <br /> work Io�which applicafion is made and I comply with the Sfafe Gonfractors Law 18.27 RCl4'and <br /> 296.200�C. , <br /> r�i/%' �,�,�,z.2,/ � ^ .�' �- �7 ///777C�S� <br /> - SiynaWre Dale � � <br />