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�LECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVIC�S <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 /> 300� Ev�i?� ri �v��r_ <br /> PROJECT ADDRESS <br /> iZvDE7t � <br /> Owner Mail Address City SlalelZip Phone <br /> � � <br /> Ten . t Mail Address City Slale/Zip Phone <br /> /�p �,�- ao�'i 3co <br /> �r �LL7 l�.?G LGG S�i�j'�7�5/d �viY �fl�Z9/ S6� �Y6 <br /> Eleclrical Cent aclor A�ail Address Ciry Slate2ip Phone <br /> P�z�,�e�L �34� <br /> � ��� <br /> State License Num�er Contracl Price o(Work <br /> S. � � . <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work lo Be Done: _ f�b'i�Gil G(f /U�J n��� M L�T"C_/L /3i15(T • <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIF�D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hemhy certily fhaf I have read and examined fhis applicafion and kno�v fhe same to be true and <br /> conecL All provisions ollaws and ordinances governing this f}�pe ol wo�k u�ill be completed <br /> u-hether specified herein or noL The granting of a pennd does not resume to give aufhonty to <br /> violafe or cancel lhe provisions olany other state orlocal law reguPting consWction or Ihe <br /> perlonnance ol construcfion. That 1 am authorized by the o�vner of this property fo peAonn the <br /> �vork!or wh�ch applicafion is made and I comply with the Sfate Contracfors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> � "` F 3♦ o �, S <br /> ignaWre Date � <br /> ��' �i� l �� <br /> � <br /> � <br />