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ELECTRICAL PERMIT �►PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereu?JpRrg <br /> APPLIGATION9 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��'�7i� — <br /> .�l�I�� Evzt'��e2� �^-'a� <br /> PROJECT ADDRESS <br /> ,S. Pck��l.T-c 1 iuZL� �CC �106 ���iKoqSu� Kc� �MCi FC U��I— ����� <br /> OWnef Mall Address Ciry StatelZip Phone <br /> \')�e� CI�'J�5 Il�(a� EvxrcQ�t-�� w�� �ucr�- 1,� f�- <br /> Tenant MailAddress S Ciry Slate/Zip �,�f�-132�orir <br /> �1-e�/-�r's��� �A��u��� ot�� f�,-y�i So,rf� ���.i�-eru�� lvf�- <br /> Electrical Contractor Mail Atldress City State2ip ctg�3 Phone <br /> M�-s � � «.�� ��� <br /> State License Number Contract Price of Work <br /> �.,,. �„� �tZI ���,G� <br /> LLw.tI4 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: (� 5' "'" ` ` � ""` �� �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF f' : "'TT LOCAL SALES TAX CODE IS 3105 <br /> I hereby a�urq qiat 1 have read and examined fhis applicaiion and know the samo to 6e true and <br /> correcl. All prowsions yf laws and ordinances goveming this type oI work v�ill be completed <br /> whother speci(ed herein or not. The granting of a permrt does not re�ume to give authonty to <br /> violato or cancel the provisions o/any other slate or local law reguPhng consWchon or the <br /> peAormance of construcfion. That 1 am authorized by the owner ollhis property to pedorm the <br /> work/or which appiication is made and 1 comply w�th the State Confracfors Law f8.27 RCW and <br /> 296.200 WAC. <br /> ��%e-�,`� G-r�-� � <br /> Signature Date <br /> E o�G(c -� � � <br />