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I _ . <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 5_�S -�Z <br /> �);?OS-1 a <br /> �� �/5 ��m�Ev-C�G-� �lJe <br /> PROJECT ADDRESS <br /> ( �'L� `I — <br /> Owner Mail Address City State/7Jp Phone <br /> Tenant Mail Addross City State/Zlp Phone <br /> _�i��e� <br /> Eleclrical Conlractor Mal Address City State2ip Phone <br /> Stale Lfcense Number Conlract Price of Work <br /> �FR <br /> Proposed Use of Building Cantact Person (Plan Review) <br /> Descriplion of Work to Be Done: ��1 � v'F Xi'fl lT/1 d" ���..�tJrc <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 cortify fhat I havo read and exem7ned this epplication and know the same to 6e frue and �� �� - /Z� <br /> correct. All provisions o(laws and orrlinances goveming this type o(work will be completed <br /> �vhetlier specified herein or nof. The grenting o(a permif does not presume to glvo authonfy to <br /> violato or cancel tl�e provisions o(any ofher sfate or local law regulafing construcUon or the <br /> perfomiance o(construction. That 1 am authorized by fhe owner of this property to perform the <br /> work lor which application!s made and 1 comply wlth ihe State Confrec(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> I,J�en u,-, �l�sn� Gl ti v � ;-.� �, \��-� �e.g <br /> ' Signature �e_ <br /> '�-� �C�J lS-c� ��2 t..��.�..��� C...� �'] CC.Q <br /> �n�..�- G.S �-`'�-P y f� <br />