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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ��✓o�, <br /> 3200 CEDAR STREET, EVERETT, WA 98'L01 �" <br /> 425-257-8810 - FAX 425-257-8857 —�v�vw.everettwa.org G--�,� ���a q <br /> APPLICATIONS ARE ACCEPTED FRGM 8 AM TO 4 PM <br /> ��"� �� �l�fr� �f��� <br /> PROJECT ADDRESS <br /> ;_'� j�- <br /> Owner Mail Adtlmss Cdy State2ip Phone <br /> TCnan� MailAddress Cdy Slale!Zi,� Phone <br /> 3�� S�sS <br /> 5ur��M�T CI.CCl$-�, I rJt, G'�3 26�ST `� NW 57"ArJwa�rj W f� i`b2�2 <br /> EleCtfiCal CoNraClor Mail Address Ciry State/Zip Phone <br /> �t >MS�(',1�1 000 K1-. �}r� <br /> Stale I_icense Number Coniracl Price of Work <br /> ��PLEx - <br /> Proposed Use ot Building Contact Person (Plan Reviev+) <br /> Descrip�ionofWorklo4eDone: LJ11-C IJ[�.J I�Uy�-ex /Z.c�G (�f�f\� S�I��J�<-C <br /> NOT[: 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 ca�tily thaf I have rearl and exarnined fhis npplicaflon end knu�i�the same to 6e true and <br /> conecL All provisions cllaws and ordinances governmg this t}�pe c/�rork�rdl he cemplefed <br /> whether spec�/ied herein or not The granting o/a pernuf does no! resurtie to give authonty to �, <br /> violate or cancel the provisions ol any o(her sfate or local law reguPafing construc(ion or Ihe <br /> per�onnance o/conshuctwn. That!am aufhorized by the o�vner o(this property fo perlornr the � <br /> �vork(or which applicafion is made and I comply�rifh fhe Sfafe Conlractors La�v 1827 RCW and � <br /> I 296.200 VM1�AC. <br /> ; � ��� <br /> ;' �pr, c. 23 �cr�g � .� <br /> Sigialurr, � Uaie � L� <br /> � <br />