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ELECTRICAL PERMIT APPLICATION <br />C�TY OF EVERETT PERMIT SERVICES �.,IO�Iz <br />32UU CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org � UJ /� f—� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />%�O �C G`_!1 �lv � �'%�� v��� l� V �G��Q� �N"'J� <br />PROJ[CT ADDRESS <br />Owner <br />Tenant <br />G� �--�T <br />Mail Address <br />Mail Address <br />�'A��� t l' D. � 7"�1-7 G!I %ti <br />Electrical Conlreclor Mail Address <br />l3rS i ��� 9/9 � � <br />Slale License Number <br />\ <br />�.e m m� r o-� <br />Proposed Use of Building <br />Description of Work lo Be Dane: <br />Stateicip <br />State/Zip <br />Slate2ip <br />�!aOD�It <br />Conlract Prico of Wori <br />Conlact Person (Plan Review) <br />n <br />YIIVIIC <br />Phone <br />Phone <br />NOTE: WIRING IN NON-GWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. �� 5� <br />.i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />/ hereby certify that 1 have read and er.amrned fhis applicalion and knmv fhe same fo be true and � W I Z ��— � �� <br />correct. All provisions ol la�vs and ordinances goveming this type of �vork will be completed <br />whefher specified herein or noL The granting of a permd does nof piesumo to give aulhority to <br />viola(e or cancel the provisions oi any uther state er local law repulating construcfion cr Ihe <br />pedormance o/construction. That 1 am authonzed 6y the owner olthis �roperty to pEdorm the <br />work lor n-nich application is made and ! comply wifh the State Confracfors Latv 18.27 RCW and <br />296.20C WAC. <br />- ��-f?l19 - - �" y._� '— <br />,Siynoture � Dale <br />