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I <br /> ELECTRICA�L PERMIT APPLICATION __ <br /> CITY OF EVEf2ETT PERMIT SERVICES ' <br /> 3200 CEDAR STREET, EVERETT, WA 98201 t?� '�' v <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I O(�30 �2G aQ�.A 1 l� S <br /> PROJECT ADDRESS � <br /> �'�VIR'2t�- �F'�� <br /> Owner Mail Addrese Clty State2lp Phone <br /> Tenant Mail Address City Stale2lF Phone <br /> <36� <br /> �t�l �lerarzic 4(R CEDRe._- OU�`f5�lc���e �� `tFsz�� �5�roso� <br /> Elecl�ical Conlractor Mail Address City State2ip Phone <br /> {-4 nn G'r� 1� Cr]'l kG R S C�o°e' <br /> S�tale License Number Conlrect Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Wod<to Be Done: W��E C�� L.l �f � <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 /> I hereby ce�tily thaf I have read and examined this application and know the same to 6e frue and <br /> conect. All provisions o(/aws and ordinances goveming thls type o(work will be complefed <br /> whether specified herein or nof. The granfing of a permit does not�resume to glve authonfy to <br /> violateorcancelttie Provisionsofanyothersfateorlocallawregulafingconstrucfionorthe <br /> performance o/consf.•ucfion. That 1 am authorized by the owner of th(s property fo perfo�m the <br /> work lor which applic ' iade and 1 comply with the Stafe Contractors Law 18.27 RCW and <br /> 296.zao fpo�{— ��3 <br /> 0 <br /> Igna ur Date <br />