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ELECTRICAL PERI�IIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES a z`o S <br /> 3200 CEDAR STREET, EVERE i f, WA 98201 7� <br /> 425-257-8810 - FAX425-L57-8857 —www.everettwa.org �. d�p7—OqjJ <br /> APPLICATIONS ARE AC:EPTED FROM 8 AM TO 4 PM <br /> ��O `1 �Gti� ��.t� <br /> PROJECT ADDRESS <br /> _.�Z^Y �eiTi vc���.30 l GG�,z �J<�v� /'c%2�t� t�X'r �151'2o C <br /> Owner � � Mail Address City State2ip Phone <br /> Tenanl Mail Address Cily Slale/Zip Phone <br /> ��o� � 7.�'St.SS_ � U.�7��tT /./� �>.Sl-C7_��c2 C ?y) <br /> Eleclrical Conl�aclor Mail Address Cily Slale/Zip Phone <br /> �S�iL � �- DZL t3Z �s��> <br /> Slate License Number Contract Price of Work <br /> /�c�5o_ <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Descriplion of Work to Oe Done: S��(/�ti G!-�ecs�o,.�__ <br />-� <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 L, ,�. <br /> 1 hereby ce�:�l�ihat 1 have read and exarnined fhis application and know fhe same to be Vue and �U �� � - ��L <br /> correct All provisions ollaws and ordinances govemrng rhis typo of work will be completed <br /> �vhefher specitied herein or not. The�ranting of a pennd does not presume to give aufhonty lo <br /> violate or cancel(he pro��isions o/an}�othe�state or loc.�!law regulnfing consfrudion or the <br /> perfomiance oI constn�ction. That 1 ant authonzed by the o�vnor o/lhis property to perfonn the <br /> work lor which application is made and 1 comply wrfh fne State Confractors Law 18.27 RCIN and <br /> 296.200 WAC. <br /> �' _� <br /> �� � 1 � � <br /> _� �lt�t t ry��t�/-'�.� � ' -Z-Z- a �� <br /> Signature '� Date <br />