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i <br /> ELEC'I'RICAL 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 /> /2 -/6--// <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���� Z ��� <br /> l7-�5 cai>F 'ls�hQn� h;Ay 5v� ry 2�3 <br /> PROJECT ADDRESS <br /> �n/LS oG �v S�IL�.'f'I <br /> Owner A1all Address Ciry State/Zip Phone <br /> On[A "f�2 <br /> Tenant Mail Address City SWte21p Phcne <br /> 3ia2rcit,t f-i2f ��t�u-1 SvTN ��t �J� p2�iNGTJn) WA R�Szz3 �-125 z44 �'f4S <br /> ElectricalConlraclor Ma1lAddress Ciry SWte2ip Phone <br /> U� <br /> �3ia�z,z�'Lf5�31 �C. Z's� o <br /> State Lfcense Number Contract Price of Work <br /> Proposed Use o(Buflding Contact Person (Plan Review) <br /> Descriplion of Work to Bo Done: � �2f /—��A��"'� T 1 T <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � I �.� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hrreby certily Ihat 1 have read and exam7ned this application and know the same lo be true and � I 1 I Z . `D� <br /> correct. All provlslons of laws and ordinances�oveming fhls type of work will6e completed <br /> whether specified hereln or nof. The grenting ot a pemut does not presume fo give aufhonty fo <br /> violate or cancel Ihe provlslons of any other stafe or local law regulating consfruction or the <br /> performance of construcfion. Thot 1 am aufhorized 6y ff�e owner of this property to perform the <br /> wo�k lor wliiclt app�cation k made and 1 comply wifh the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC�"� <br /> � <br /> =�i�' `� Iz I6 w <br /> ,%� ig ure Date <br /> �' <br />