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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.everettwa.org 41!��!/;"6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ����g ���� :���,� L��i s� ;�e l <br /> PROJECT ADDRE S <br /> c�verc(�-� y yJ(i:��'t�C'>� �C,�f�1 /�i������C' .�It: �,C'A4' Qr <br /> Owner Mail Address Cily State2ip Phone <br /> Tenanl MailAddress City State2lp Phone <br /> CS� f/c c�r�� ��S 3� S�C��,����=/U� 5��; .�-vcb� G✓,'� `r �'/`� .X�60-�Z-s�;� <br /> Electrical Contractor Mail Address Cily Stale2lp Phone <br /> � S �� L �� �IS-SG3 -?�� � <br /> State License Number Contrec!Price of Work <br /> �C—'•lc, A� -SJc C � <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriplion o(Work to Be Done: GL L�L'� '�C'���/, � (% �:��/I /�rt �%�� / 70r �C'W� Sa,�� <br /> NOTE: WIRING IN NUN-DWELLINGS IS REQUIR'=D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y fhat 1 have read and examined this applicafion and know the same to be frue and ���� ��� <br /> conect. All provisions ollaws and ordinances governing fhis type oI work will 6e complefed <br /> whether specified herein or noL The granting of a pemut does nof presume fo give aufhonty to <br /> violate or cancel the Provisions o(any otlier state or local law regulating construction or fhe <br /> perlormance o/consfruction. That I am aufhonzed by the owner of this properfy fo perlorm fhe <br /> work for which applicafion is rnade and 1 compty wifh fhe State Contracrors Law 18.27 RC W and <br /> 296.200 WAC. � , <br /> ;.�: <br /> % � <br /> , ,.. - _ �; l % �_C'C <br /> ��.-� � 'i� � � �-, � <br /> - S'ynaWre Dale <br />