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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � �13-11 <br /> 4Z5-257-8810 - FAX 425-257-8857—www.everettwa.org ���D7���� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> sa�9 �,�,����� <br /> �-i- S',���r� �/9 Y �v��.�TT <br /> PROJECT ADDRESS <br /> Owner Mail Address City StalelLip Phone <br /> ._� ly�7n �{v�'��—�rv'1L��.nn ��� g'x� �e <br /> Tenant ' / - hlall Address City Slate/7Jp Phone <br /> ��J/L[e.p,� �. /�US �.3 cf•r0� <br /> i <br /> Electdcal Contrector Mait Address City Stale2ip Phone <br /> Slate Lfcense Number Conlract Price of Wark <br /> Proposed Use of Building Contacl Person (Plan Revfew) <br /> Descriplfon of Work to Be Done: _r�#i—� �CC�YS �y�s�.rJ�l�7.il� ' �� �— �� <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 <br /> lliereby certi/y fhaf I liave read end examfned thfs appllcafion and know fhe same fo 6e true and <br /> correct. All provlslons of laws and ordlnances goveming fhls type of work wlll be completed <br /> vihc�fher specified herein or noL 7he granGng of a permit does not presume to glve authonty fo <br /> vlolateorcanceltlie provlslonso/anyotherstafeorlocallawregulatingconstrucfionorihe <br /> perlorniance o/construction. That I am authorized by the owner ol ihls property fo peAorm Ihe <br /> work!or whkh appllcatlon!s made and 1 comply wifh Iho State Confrac(ors Law 18.27 RCW and <br /> 29G.700 WAC. <br /> � � <br /> �-il'�i�/! - - /3�// c� <br /> 'Slgnat re� �Date ' O�l —OJ <br /> 1 � <br />