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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9B201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org 6 `� S—�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C II DFj—p g� <br /> �►6►a FV���,,�< « ��,� Su,�� �.� <br /> PROJECT ADGRESS <br /> i <br /> �•� � %Y� �r�1�1��� C%1VIQ rl'YIC'LL� ��'n0,^aF� <br /> Owne� MaI ddress Clty Stale2lp Phone <br /> 'J1�Cn��U', �c,r.,�C� <br /> Tenant Mait Address City Stale/Lp Phone <br /> y�r- �l)�--)9�g <br /> �� �,���, t=I� a�� ►�.� a►��� s; sr 3 ���L,�11 <br /> Electrical Contractor Mail Address Cily State/Zip Phone <br /> �1�v c�-, �� 2`Fi I v aj � ��Q �� - <br /> Slale License Number Contract Pdce of Work <br /> ��u. . <br /> Proposed Us of Building Conlact Person (Plan Review) <br /> Descripllon of Work to Bo Done: �. � /�i 7� , � � nOv4••�+-,an� <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 3105 �� ��.�/ _ ��'C'� <br /> 1 here6y certily fhat lliave read and examined this application and know the same to be(rue and �K� � <br /> correct. All provlslons o(laws and ordlnances goveminc�th7s type of work will be completed <br /> whefher specified herein or not. The granting of a permit does nol presume fo glve authority(o <br /> violafe or cancel the provisions of any other state or local law regulsting construction or tha <br /> performance ol construction. That 1 am authorized by the owner o!this property to peAorm the <br /> work for which applicafion Is made and I comply with fhe State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � l G / 5 z �� I <br /> �'"� Dale <br />