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C �� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ��3 `� Z <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-88�7—www.everettwa.org �� �s-o a7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> LFg3t Ev���a.t-e-� h t�2`� <br /> PROJECT ADDRESS <br /> lS���v ScH�c�bev G 1tSSo� �SO Oru� S *� 21D �Ccc�t{1,� ,,J-!� ��6L0 � <br /> Owner Mail Address City SlatelZip Phone <br /> T V`-t�h� l f., <br /> Tenanl MailAddress City Slate2ip Phone <br /> �IRV � '�; ���h S �Z�y I�G tZ�-` S�I ���vhove �A Q�oZf� <br /> ElectricalContractor MailAddress City Slate2ip Phone <br /> /�oc <br /> �La2isr R2 � 13(� <br /> Slate License Number Contract Price ot Work <br /> �«�� G--�-�-�, <br /> Proposed Use of 8uilding Contact Pereon (Plan Review) <br /> Description of Work to Be Done: <br /> i�Gv {� l.c�� �� I � �kW� l��^GLIfC' S �C� h <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRily thaf 1 have read and examined fhis applicalion and know fhe same to be frue and �I�� ��� <br /> correcf. All pruvisions ollaws and ordinances goveming Ihis type ol work will be completed <br /> whefher specilied herein ornof. The granfing o/a permd does not prasume to give aufhority to <br /> violate or cancel fhe provisions of any ofher sfafe or local law regulating construction or fhe <br /> peAormance o/constn�cfion. Thaf 1 am authorized by fhe ownero/fh�s property to pe�Iorm the <br /> work Ior which appl�cafion is made and 1 comply with fhe Sfafe Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �'��'S�t,{�t,U- � �e� S — � — 1`Z <br /> � ignalure Dale <br />