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ELECTRiVAL PERMIT APPLICAT!flN <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 /> � { �,( � �C�S"{� ��Cn I�bv�.�l Q�� <br /> PROJECT ADDRESS <br /> �T' � ' K-CC� If vCj�� �PS� �C"*1 ��E� ��� UJ�'4`N�t�P��BZo3 �s-7Go 3 <br /> OwnCr Mail Address City Slate/Zip Phone <br /> Tendnl Mail P.ddress Cily Slate/Zip Phone <br /> ��Asst� �.(�c�k, �?���� �Y� �,�e��i � , -�, ce�-�c� ti.��-.���a3qi <br /> Eleclrical CoN�aCio� Mail Address Cily Slate/Zip Phone <br /> ��55 c_1 I 53��,.� <br /> Sfate License Number Contracl Price o(Work <br /> � <br /> 'K'ESI�C`�`NI.Pi ���N �CiSS�/', <br /> Proposed Use of Building Conlact Person (Plan Revie�v) <br /> Descriplion o(Work to �e Done: �� ��aC� ��A 5 PC�'�l�C� �Q/1(� I <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 fhat I have read and examined this applicafion and kno�v the sarne to 6e We and <br /> correct. All provisions o/laws and ordinances goveming this f}�pe o(a�ork will be cornpleted �e� -�,roy <br /> whe(herspecdied herein ornot The c�ranfing o/a permd does not p�esume to give authonty to <br /> violale or cancel the�rovisions o/any ofher sfate or local law regulating consfruction or fhe <br /> performance o/cons rucfron. Thaf 1 am aufhorized by tlie o�vner o/this propert}�to perform the <br /> work Ior�vhich application is made and I cornply wifh the Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> '�AC,.� �--- � -`� �0�— <br /> Sic�nat re Da1e <br />