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ELECTRICAL PERi3111T APPLICATION <br /> CITY OF EVERE7'T PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERE TT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> -; s � �' ���� i3�1 � � ,� �'E <br /> PROJECT ADDRESS <br /> � ��� Lw'? 1� �� S�N�y�f /� 3i � oi�11�o�3D ��V�'!-1' lT Ltl ,=1 �r � j � .7lv•�(� c, �� <br /> Owner Mnil Addrecs Cily SlateiZlp Phone <br /> =�1.J r1 E' j� <br /> Tenant 6ta11 Address Glly S�atE�Zip Phenc <br /> ,,�i,Jl� L � <br /> ElectricalContractor 67�i�Address Ciiy Stata2lp Phone <br /> Stale License Number Coniract Price of Work <br /> Proposed Use o(Budding Contacl Person (Plan Revic�:+) <br /> Descriplion of Work lo Be Done: N t��� � �� ���` � �� G- L�� � �� .� ��� �7 �/� ��� 7� '� <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 certily fhat I have read anA examined fhis application and know the sarne to be true and �U�?G`�� � I �;' � <br /> cunecl. All provisions of laws and ordinances governmg this type o/�vork will be completed <br /> whefher specilied herein or noL The granling ol a pernuf does notl�resurne fo give aufhorify to <br /> violafe or cancel(he provisions ol anv ofher stafe or local la�v regu afing consVucfion or the <br /> perfomiance o(construclion. Thaf I 5m authorized by the owner o(this property fo perlorm fhe <br /> work/or which application is made and I compty a•ith Ihe S(ate Contractors La�v 18.27 RCW and <br /> 29�.200 WAC. <br /> � . <br /> . � ,- / <br /> � , . � ,,�� '� (� 3� v )� <br /> SignaWre Dale <br />