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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -�vww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/�D��67 <br /> �� �,�-003 <br /> 3zz2, �MP�A�r� �,, �_ <br /> PROJECT ADDRESS <br /> � SG PI�PCR-�1CS -- <br /> Otvner A1ail Address City StatelZip Phone <br /> TenaN Mail Addicss City Slale/Zip Phone <br /> ti25 30� S75n7 <br /> �,�rnrn\"i" C�Cc,-r�-�� �,v� 6'Zo3 w�5fi 51" n�W S"d���asD wA �SsZ;2 <br /> Eleclrical Contraclor M1fail Address Ci1y State/Zip Phone <br /> S�1M^n �C, l 6CJ0 �Z. � � OUJ <br /> State License Number Conlract Price of Work <br /> -r2z P�ex <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> �W r�'1 O�a"� <br /> Description of Work lo Be Done: w 1�� N Ct.1 �-� � ����� �"� <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 /> I hereby cerily that I have read and examined Ihis applicafion and knou�fhe same fo be frue and <br /> conecL All provisions ollaws and ordinances go��ernmg this fype c!work will be completed <br /> rohether specdied herein or noL The yranfing ol a permd does nof resume to give authonry fo <br /> violate or cancel fhe provisions o/any other sta�e er local law reguPting r.onstruc6on or the <br /> peAonnance ol constructien ihat 1 nm aidhorized by the ou�ner o/this propeRy to perfonn the <br /> work(or which application is made ard 1 comply�rith(he State Contracrors La�v 18.27 RCW and <br /> 296.200 W,AC. <br /> V��--- N�U 1 7�0� <br /> Signature []atc <br /> ,7��_ .�a' , <br /> ,, : � � <br /> � . _ <br />