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ELECTRICAL PERMIT APPL�CATION , <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � Z `-�y`�i <br /> 425-257-8810 - FAX425-257-8857 -�w✓w.everethva.org �0��/�3/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> G�1'''>c. C D�'i�/ �'�nlu� , I�v4 ��,203 <br /> PROJECT ADDRE S <br /> � i-- �12S-,Z/o <br /> �,. Q ��.��u 4831� Cvl/;�y ��e��� �"c�c�f I,vA-�fi82o3 �' guz2 <br /> Owner Mail Address City State2ip Phone <br /> Tenant Mail Address City Staie2ip Phone <br /> Qc�'�t� <br /> E�ectrical Contraclor Mall Address City State2ip Phone <br /> Slate License Number Contract Price of Work <br /> �/yC6�HJ� �Sf��1t9 '�i' <br /> Proposed Use oF Building Contact Person {Plan Review) <br /> Description oi Work to Be Dono: ��C�C9� CtJI eI N r y'�� N� ����G/ �'��`r <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thal I have read and examined fhis applicafion and kno�v the sarne to 6e fnie and <br /> conect. All provisions cl laws and ordinances governmg tlus fype ol work will be comp/efed �C���� —(!�j� <br /> whefher speci6ed hemin or noL The�renfing o/a permd does not p�esume fo give airthonty ta <br /> violafe or cancel fhe r�rovisions ol any other sfate or local!aw regulating consfruction or tho <br /> peAomiance c/conslruction. That 1 am authorized 6y the owner o/this propetly to peAorm fhe <br /> �rork Ior which applicafion is made and I comply n�it/�!he Stato Confractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> , (��iz�._ I ,.(��t !6` � "�'7 <br /> ( SignaNrv . � Date <br /> � <br />