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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3 q 3 / I=r,�et„ /�y� <br /> PROJECT ADDRESS <br /> ZoG• Z .�j= yo <br /> ►'��%� 1�000s 393J 1='r;�K, ���n�lr.�}� 9�z.�i � <br /> Owne� Mai�Address Cily StaleRip Phone <br /> S9n,L <br /> Tenant MallAddress City Slate2ip Phono <br /> ' / W r? <br /> �/a��?M ��i�i'i� lI�ID /�,v,,i// Ck �,C�K> �/<rr� ��2d1 l� 23= y�)•o83Z <br /> Eleclfical ontfaclor MailAddress Cily State2ip Phona <br /> I/ulle�c 14/NA g/�� � <br /> State License Number Contract Pnce of Work <br /> ��PS/(�Gn cc <br /> Proposed Use oF Building Contact Person (Plan Review) <br /> Descnption o(Wnrk to Be Done: �i,�la�C �� �IH�Y ,�G1jJt� a✓1 �7�riNSL <br /> p'— <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 certily that I have read and examined this application and know the same fo be true and <br /> correcL All provisions of laws and ordinances goverrong this type ol work will be completed <br /> whefher spea(ied herein or noL The granfing o(a permR does notp resume to givz authonry to <br /> violafe or cancel the provisions o/any other state or locallaw regulating consfruchon or the <br /> peAormance o(constn�ction. That 1 am aufhorized by the owner o/this property to per/orm the <br /> work for�vhich application is made and 1 compty wifh fhe State Contractors Law 78.27 RCW and <br /> 296.200 WAC� <br /> � 7 / r <br /> !i7 L�7 <br />' ignature � �e yCj`7G�"l�3 <br />� <br />