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ELECTRI�AL PERMIT APPLICATION <br /> CITY OF EVERET'T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE7T, WA 98201 I� 9 �/ <br /> . <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org �O/ QI `��� <br /> b <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I 0 $��l t-�D��-s `�v��2 <br /> PROJ CT ADDRESS <br /> ��'}T�2.cc(� �,���,�T3u� lZ��� LS �A�2S�� �f?-�-33�If�� <br /> OWnef PAail Address Ci�y Stale2ip phone <br /> —_�� <br /> Tenanl P:1ail Address City Sta(e/Zip phone <br /> �'6tZ t�P� �N�- ��o E3v����� 1,s L.�� �8�k �1��-3�-oss�, <br /> Eleclrical COnUaCtOr Mail Address City Slate2ip Phone <br /> j�G(L._ +`��t�C� f 62�24��i S�ic � <br /> Slale License Number Contract Price,f Work <br /> W Y'N-" ,I"'W�/11�c)'�1��'� �C�j('T' 1' �-V��''�"�� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work to Bo Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT L6CAL SALES TAX CODE IS 3105 <br /> I hereby cerlily fhat I have read and examineG this applicalion and know fhe same to be We and �GU-p�-L�'--, <br /> correcL All provislons o/laws ond ordinances governmg fhis fype ol work will be complefed <br /> whefher specified herein or noL The grantin�ola permif does nof presume to give aufhority fo <br /> violate or cancel fhe provisions o/any other sta/e or local law regulafing consfrucfion or fhe <br /> pedo�mance of construction. That 1 mn authorized by Ihe owner o/this property fo perlonn ihe <br /> work Ior�vhich applicafion is made and I comply with the Sfafe Confroctors Law 18.27 RC W and <br /> 296.200 WAC. <br /> i <br /> �/ `_ - �I -`/ <br /> Signalu`re �! � D3te� <br /> \ <br /> J <br /> . <br />