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ELECTRICAL PERMI f APPLIGATION <br /> CITY OF EVE.RETT PERMIT SERVICES <br /> 3200 CEDP,i� STREET, EVERETT, WA 98201 <br /> 425-257-881� - FAX 425-257-8857—www.everettwa.org <br /> APP!ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _ �Qz3 EtJe2 C`r�2ee��y Wi�y , FvP�t�+l- <br /> PROJECT ADDRESS <br /> Owner MailAddress Cily SlatelZip Phone <br /> �?M`'A �1�1(��1�y5 /�(� IS¢! Sf . Sc�ite $ ��lnDer�,k4.y826�1 �o-$as <br /> TenBnt MailAddress Cily StatelZip Phone��3K <br /> Dal�ls Ua-lle� �Iec�;� 521 �. v���ru'� Ac�.. .�✓�I�n�kn c�'�. yfsz3� �o�ssuy <br /> Electrical Conlractor Mail Address City StatelZip Phone <br /> _ Dr+KL sv� to � �v `� ��f4o� oa <br /> State License Number Contract Prirz of Work <br /> l�A��- �212.�1��5 <br /> Proposed Use of Building ' Contact Person (Plan Review) <br /> Description of Work to Be Done: /T�DIJ ^+ D�1 L'�-�P� L + C�• Z�,�"17'(� <br /> G� 2ci/if �n F�� �.o ��ian �. TWo �'-�S'�2 �<S7�2S, <br /> ��'rce , l�hone �3o�D . <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 3705 <br /> I hereby certi/y(haf I have road and examinod lhis application and know the same fo be true and <br /> correct. All provisions ollaws and ordinances goveming this type of�vork will be completed <br /> �vhefher specified herein or noL 7he granting o/a permit does not resume to give au(honty fo <br /> violale or cancel the provisions ol any other state or local law reguPating cons�ruchon or the n <br /> pe�lormance o(conslruction. Thaf 1 am aufhonzed by(he owner ol this propeAy fo pedorm fhe , h <br /> work lor which applicafion is made and I comply with fhe State Contracfors La�v 78.D RCW and � ) <br /> 296.200 WA � /� � <br /> ��� �,���1� �<6-0� � <br /> Signalure Date � <br /> ��_ <br />