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; � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857—www.evereVmYpRrg <br /> APPLICATIONS ARE ACCEPTED FROM 9 AM TO 4 PM <br /> ��« ���a�e�� w�� <br /> PROJECT ADDRES <br /> ljTcUe� k �ei✓� l�6�I �u��e e K t,va� �U�1'e�7� Glt�- �� ao Y <br /> OWner MailAddress Ci StatelZip Phone <br /> ��(�ti� (�ok�(0. IUGL( EU�l�q('�e�w�,.� �utrt.� (�/f�- �(82� �f <br /> Tenant Mail Adcross � Cit� Slate2lp Phone <br /> �G.�-Z��q H 't"1�1V,(f��5/l.rq �lOcg f�S/ l l Soct� V'��NJ�.I.�VCJ�lO� W�- l c42-73 <br /> ElectriralContr or MailAdd ss City Stale2ip ���yr�Y_c3P�ho� <br /> � � <br /> G�{�S�O I '�� (�' <br /> State License Number ConVact Price of Work <br /> c�l' �� � �`l(Cr� � <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description of Work to Be Done: �'�5/`C/�' ` � W� S�G � '�t� `r��SS ��ize <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 /> 1 hereby certify that 1 have read and examined this application and know the same to be�true and �b��i1 <br /> correct. All provisions ollaws and ordinances goveminq this type of work will6e completed � <br /> whether speci(ed herein or not. The granting o/a permrt does not resume to give authonty to <br /> violafe or cancel the provisions ol any ofher state or local law reguPting consfniction or the <br /> performance ol construction. That I am authorized by the owner ol this properfy to perform the <br /> work/or which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � _ 2� 7 <br /> SignaWre Dale <br />