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�- <br /> ELECTRICAL PERMIT APPLIVATION <br /> CITY OF EVERET7 PERMIT SERVICES f� _� �_�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everetlwa.org ������a9 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 5 f� $ Gl.eNwooi� �v �� <br /> PROJECT ADDRESS <br /> ��� � Mall Address City StalelZlp Phone <br /> Tenant Mall Address Ciry SlatefLip Phone <br /> 'f�5-a6.�- 1 a 8�. <br /> � a�n� e�N � ��+�o a�� �� sw ����, Er� w►� 9 �ao3 <br /> Electrical Conlractor Mall Address Clty StatefLip Phone <br /> wR � NGCxqoa�' K �� 1 �, 000• oD <br /> Stale Llcense Number Contract rice of Work <br /> c�� i 5r -�c � <br /> Proposed Use of Bufldiig Conlact Person (Plan Review) <br /> Description of Work lo Be Done: J7� b 01�� A �EN�,��1�� 2 c,E pT� <br /> � r�� A� l� ��_�1C� `rF.l.. �Qf1L� I�l� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO f=EE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 / <br /> 1 here6y certily ffiaf 1 have reed end examined tliis appllcatlon and know the same to 6e frue and �'� �� — �'Z� <br /> correct. All provlsions o(laws and ordinances goveming this rype oI worir wlll 6e compfeted <br /> whether specified herein or not. The grenting of a pemut does not presume to give aufhorify to <br /> violate or cancel the prov(slons of any other stafe or local law regulsting construcflon or fhe <br /> peAortnance of consiruction. Thaf 1 am euthorized by the owner o/fhls property to perform fhe <br /> work Ior which applicafion!s made and I comply with fhe Stafe Contrectors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Uw1 �l -1$ - � 1 <br /> SlBnature Dale <br />