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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 /> .:� �v �.� �%/�o f w A.� <br /> PROJECT ADDRESS <br /> �(.%�� /r .L r��rr,ot/.9r.j � L G <br /> Owner Mail ddress City State/Zip Phone <br /> �I�W S'FIZ <br /> Tenant Mall Address City State/7Jp Phona <br /> /1/ot'��trr� � > >�� .�`/r -�� c C.O� -4i 32$Oy <br /> Electrical Conlraclor � Mall Addrass City State2lp Phone <br /> State License Number Contract Prfce of Work <br /> NPtN S�R <br /> Proposed Use of Buflding Conlact Person (Plan Revfew) <br /> DescripQon of Work to Be Done: ��G / / Y Y�.t� �v�✓ �y _�a�C �d AynlO r/l.� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. �O� <br /> CITY OF EVERETT LOCAL SAIES YAX CODE IS 3105 <br /> 1 hero6y certify that 1 have read and exam(ned this applicafion and know the same to 6e frue and � 1 ZO2 _ �'�� <br /> correct. All pruvlslons of laws and ordinances goveming fhfs type o(work will be complefed � <br /> whether specified herein or not. The granfing o(a permit does nof presume to give authority to <br /> vlolateorcancelthe rovisionsolanyotliersfafeorlocallawregulaGngconstrucfionorthe <br /> performance ol cons�ruction. Thaf I am authorized by fhe owner o/this property to per(orm the <br /> work for which appllcafion!s made and 1 comply wifh fho State Contrac[ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> %�•,--����.� �7�aa��� <br /> Signature Dale <br />