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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMI7' SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 3 7—� Z <br /> 425-257-8810 - FAX 425-257-8857–www.everettwa.org <br /> �/2�13--�35 <br /> APPLICATIONS ARE ACCEPTED FROht 8 AM TO 4 PM <br />� � <br /> ( O�i I O I-�o �-��.' 21 �1� <br /> PROJECT ADDRESS <br /> C�C��(� f i N c,ti-�- �RvS SAM� �s s �-� �,��_ <br /> Owner Mail Addross City SLale2ip Phone <br /> � _ —_ <br /> Tenant Mail Address City Slale/Zip Phone <br /> �O�ssw ��� �cA� �.D P'J � �`� �1r �20� �}25 33�r-Za�r l <br /> Electrical Contraclor Mail Address Cily Slate2ip Phone <br /> �C' � '��PC�' � l� � .� <br /> Slate License Number Conlracl Price of Work <br /> C�'—�lsc� Q��� L� <br /> I'roposed Use of Buildi � Contacl Person (Plan Review) <br /> Descriplion of Work to Be Done: �N S��� 2� �� P��-- � �� ST� <br /> ��l i � <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 ���3 _ �3� <br /> 1 hereby ceriily Ihat 1 have read and examined this application and know fhe same fo be true and <br /> r.orrect. A/l provlsions o(faws and ordinances goveming fhis type o(work will be complefed <br /> �vhether speci�ed herein or noL The granting o/a pemut does not presume to give aulhonry to <br /> violafe or cancel the provisions ol any other stafe or local la�v regu/pting construction or fhe <br /> periemiance o/construction. That 1 am authonzed by the owner o(Ihis�roperiy to pedorm the <br /> work lor ivhich applic�n is nade and 1 compty with the State Contractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> �� ��7.f�Z _ <br /> Si9naWre Date <br /> I <br />