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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM JO "a5� !/ <br /> E�li�o -�s3 <br /> �I a z c�II�� !��- �2 �r w� g�-��� <br /> PROJECT ADDRES <br /> I��Ss��i, p,��,��oi�Z� LLG _ <br /> Owner ` � �— Mail Address City SWIe/Zip Phone <br /> Tenant Mail Address City State2lp Phone <br /> � �,5i�,� if?�3 �, � r(g��ist- sl�>,-.e(��,z, ,��r�- ���� ��1=y��-is <br /> Electrical Conlractor Mali Address Clry State2fp Phone <br /> �-L7C HUS�i+i�� `�)�-f�� ����-a.� — <br /> State Lfcense Number ' ' Conlract Price of Work <br /> u-ys--��J3 —�5�� . . <br /> �e 5� �r�t��,C_ —� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> DescripUon of Work lo Bo Done: �5���`'�f� �� �"`Y1� ��'re' �„�n�K �Q������ � ���'� S W <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 here6y certily that I liave read and exemined fhis applicatlon and know the same to 6e Iruo and �.. �I 1�—�3� <br /> cortect. All provlslons o/laws and ordinances goveming thls rype of work will be completed <br /> wliether specllled herein or not. The grenting of a permit does nof presume fo glve authority to <br /> violate or cance!the provisions ol any other state or local law regulating conshuction or fhe <br /> perfonnance of construction. That 1 am authorized 6y fhe owner o/fhis�roperty to peAomi fhe <br /> work for which applicafion is made and 1 comply with Uie State Confrec(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� � 5l � ��J�t � ������/l <br /> Slgnalure Dale <br />