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ELECTRICAL �'ERMIT APPLICATION <br /> CITY OF EVcRETT PERMIT SERVICES <br /> 3200 CEGAR 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 /> /✓�jL l C��M I ��1/7N �9(-�}- — <br /> PROJECT ADDRESS <br /> G i s i4 I,1 v,/�t'vs��, /�ic� G:�,�.. /�,�� /l+i� _�+..ri �•��� ff <br /> Owne� Mail Address Cily StatelZip Phone <br /> > <br /> enant Mail Address City StatelZip Phene <br /> —lc�i�u[T �/<<(�ic .X �c 5� � 7 li'isri3/ it� w,�� s //Y c�>! ��r �o Y t s�s'�c �s�Lf— <br /> Eleclrical Contraclor M11ail Address City StalelZip Phone <br /> CJ4���r r�r C�;��s"i'i� �-so� ��.. — <br /> Slale icense Number Conlracl Price of Work <br /> �-ci .c� 'Y' <br /> Propose Use o(f3uildiny Contact Person (Plan Review) <br /> Description of Work lo Be Done: %-/r'c'�i' <<r� C-�•t�i�ti' <br /> IJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> j CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certi(y Vhat 1 have read and examined this application and kno�v the same to be true and <br /> correct. All provisions of laws and ordinan�es govermng this type ol work�vill 6e completed <br /> whether specdied herein or noL The granfing oI a permit does not resurne to give aufhority ro <br /> violafe or cancel fhe provisions oI any olher state or local law reguPting construchon or the <br /> performance o/consfruction. That 1 arn authorized by the owner o/this property to perform the / <br /> work(nr which application is made and I cornply�vith the Stafe Confracfors La�v 18.27 RCW and � <br /> 296200 WAC. �f <br /> i I ' , � a <br /> /' // � <br /> , <br /> � l C s�° C� <br /> lr��-�l%�i � �� � �— <br /> Signatu� . Dale <br /> t <br />