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l <br /> 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 /> �5dz Cv��-+�� b�.. �� ��1f��� <br /> PROJECT ADDRESS <br /> -ua Ve,�i N�� ��.��.�,�� <br /> Owne� Mail Addross Clry Stalefllp Phone <br /> Tenanl Mail Address Cily State/Zip Phono <br /> t�'�Cu1.kD �'Y►v ,�, �o�o� 2�1�1 sn o�,^;^;.,� i�ln G£�L�t � <br /> Eleclrical Contraclor Mail Address City State/Zip Phone <br /> ���, r- �r 9'7�.�� �� bh�� — <br /> late Licanse Number Contract Price of Work <br /> N s-�r2 �v�;�. <br /> Proposed Use of Bu(Iding Contact Person (Plan Raview) <br /> Description of Work to Bo Dono: lA.) 1 ��� - ���'�'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 certify fhaf 1 have read and examined this applicalion and know fhe same fo be true and G�Q�O— l �j <br /> carect. All provisions of laws and ordinances goveming this rypo o(work will bo completed <br /> whether specified herein or not The granting of a pemuf does not rosumo to give authonry fo <br /> violate or cancel the pro��isions of any ofher sfate or local la�v reguPafing construction or 1ho <br /> perfomiance of conslruction. That 1 am authonzed by the owner ot fhis property to pedomi the <br /> �vork lor which applicafion ls mado and 1 compty with Iho Sfate Contrectors Law 18.27 RC W and <br /> 296.200 WAC. <br /> l( �, � l���J; i�,���� i �`� �� 5 /l D <br /> �""' Signature ale <br />