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ELECTRICAL PERIVIIT APPL��ATION <br /> CITY OF EVERETT PERMIT SERVICES a� vo 6 <br /> 3200 CEDAR STREET, EVERETT, WA 982Q1 3 -' <br /> 425-257-8810 - FAK 425-257-8857 -www.everettwa.org L�0 6� 3 ��d� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� J 1� �,1 ��� f-� Jr.�t r r::. <br /> PROJECT ADDRESS <br /> CqMo � �-a7iJJ:;v�'�< �� % �,e�rh �ov�h_ <br /> Ownel MaiIA ress Ciry State�Zip Pnone <br /> c,� �'��nti r��Y�•.� aa�o ._�:��1��,� r�,�� , �,�,�r� , �,�r�. - ���a� <br /> �enant Mail Address City SUle2ip Phone <br /> Cf1X � <br /> Eleclrica ontractor Mail Address City Sta�e2ip Phone <br /> �J I Sc'�D� <br /> Slata Licenso Number Contract Pncc of W�rk <br /> 'rC P�r i�'N�iq � <br /> Proposed Use of Building Conlact Person (Plan Reviow) <br /> DescriptionofWorktoBoDone: �io�n[T c A�� ��X L9�R�i.�.: •1-Rt�n� �Yt� Cu.eRe•.JT� DN,Vr� <br /> tY+X' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerlily fh2t 1 have read and examined Ihis applicafion and kr�ow fhe same lu be true and <br /> correct. All prqvisions o/laws and oidinances govern;ng this type ol work will be comp/efed <br /> whelher spetdied herein or noL The grantinc�ol a permit does nof resume tc give authonty fo <br /> violafe or cancel the provisions o/any ofher sfate or loc.:l law repuPfing consWcfior or fhe <br /> perlomianr,e ol conslruclion. Thaf I am authonzed by the owner o/this�roperty to per�mr fhe <br /> work lor which applicafion is made and 1 comply wifh fhe Sfafe Conhactors Law 18.27 RCW and <br /> 29f.200 WAC. <br /> _L. �� ., ac> -1 ^ `.�,�b � <br /> � nawre Dale .� <br /> Crf �,� .j _ / `, <br />