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ELECTRICAL PERM�T APPLICATION <br /> CiTY OF EVERETT PERMIT S�RVICES � `� 3-� g <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -v�nvw.everettwa.org ��fd p -r'j�p] <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO -1 PM <br /> �7z� /�.r�tl��z�,�e. ����,�-- <br /> PROJECT ADDRESS <br /> �a D�yf�Zi N/)- ��,v �� �7� � �����-f ulf�Vt i1- S'�za� <br /> Owner ldailAddress �itv Sta� 2q/ ���3 �G PhGric�� <br /> C.. �� <br /> Tenant hiail Address Cip• Sl.le2ip Fhenc <br /> — 2 !U� — —3�/!� —�� <br /> Electrical Contractor Ata�i Aodress city State�Zip Phone <br /> Slale License Number Contract Price of Work <br /> � �i �i.�uw� <br /> Proposed U e o uil ing J Contacl Person !Plan Review) <br /> Description of Work to Be Done: '^'�'�" � <br /> � y <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> GE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 'CJ ��'� c7 � <br /> I hemLy certily fhaf 1 have read and e�carnined this applicafion andWio'�v fhe same to be We and L� <br /> � conect. All provisions o/laws and ordinances�ovem�ng lhis fype ol�vork will be complefed <br /> �vhofher specilied herein or not Tlm c�ranfing o(a pemuf does nol rosume fo give airthonty to <br /> violate or cancel fhe�rovisions ol any ofher sfafe or local law rec�uPtint�consVucfwn or fhe <br /> perfo�mance olconslrucfion. That 1 am aufhorized by the owrter d fh�s property to perlorm Ihe <br /> work lor whi:h applicafion is n� de and 1 compty wiih fhe Sfafe ConV�ctors La�v 1827 RCW and <br /> 296.200 INaC. <br /> �n.�.lirc /� '"_� (/ <br /> I <br /> _— _' _ <br />