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� tv. <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ���-�p <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> �i�o.6-os z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ` ���0 <br /> � � -� �ti���,,���� ��,y. <br /> PROJECT ADDRESS <br /> OWner Mail Address City Stale/Zip Phone <br /> �/_ ' � 1����f � �- `/8 <br /> YC�L;;,!;i ���'ip,� �:;.�ti' Sf+'.� �/���� I�:i'�CjytGA LG�I� � — <br /> _� <br /> Tenant ° Mail Address City State2ip Phone <br /> s�orT F�Fcn°�e «� Pv�a-� 3a��- ,e�r,�l��L�C w� �'��> <br /> Electrical ConUactor Mail Address City State2lp Phone <br /> S'Co7r ��i' ��32c,S� �'.5av.w <br /> State License�umber Conlract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: �r�'S�Lc�(� L.G�:� S/Ci-nJ <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 /> !hereby certi(y that 1 have re�+d and examined this application and know the same to be true and <br /> correct. AI!provisions o(/aws and ordinancos goveming this type o/werk will be completed ��(�Lp ��J"�� <br /> whether soecified herein or noL The granting of a pornut does not presume to give authonty to <br /> viola(e or cancel fhe provisions of any other stafe or local law regulating consfruction or fhe <br /> perfem�ance c�constiuction. That 1 am authonzed by the owner of fhis�roperly to peAorm the <br /> work Ioi which application is made and 1 comply with fho State Contractors Law 18.27 RCW and <br /> 29ti.200 WAC. <br /> ' � �5 � <br /> ��1,�P U 6/( J�'7 <br /> Signature 1� Dale T— <br /> / <br />