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ELECTRICAL f�ERMIT APF'LICATION <br /> CITY OF EVERETT PERMIT SERV@CES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-:57-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i C�;� '� r{L,-*� ( �-�- <br /> PROJECT ADDRESS <br /> ��� 3:37 �,y <br /> (,-l�c�.r� � �-�-�.,�l.r !o,�� j,J����- �x ��,w�-�-G^1" 1� +� `'i��C <br /> Owner MailAddress City Slale/Zip Phone <br /> Tenant Mail Atltlress Cify Slate2ip Phone <br /> ie - � F�.�.�,l�ti �-�-., F'..341ti'��• � � Mc� Y•� ;.� �4 9Fa�a .3 k� �r�'�/ ���+ �� <br /> Electfical Contractor Mail Adtlress Cily StatelZip Phone <br /> L-�� i a1 Y G�s I�Q 93 c�2(C `� e�3°� <br /> State License Number Coniract rice of Work <br /> Proposed Use of Building Contact Person (Pla�Review) <br /> � Description af Work lo Be Dane: � Y�— i�� �'� "` � ��-#��o<'-e-r�"�'�"` '� �"'�� <br /> � <br /> \7C�{-��,c�� aq..• -n1,2.�.--( <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 /> f hereby certilv that I have�ead and examined fhis application and know the same to be true and � 1 <br /> correr.L All pi, �isions ol laws and ordinances govemmg fhis rype ol work�vill be completed � ' Z� u �- � �V <br /> �vhelher speaned herein or noL The granting o!a permd does not presume to give authority to <br /> violate or cancel the provisions o!any other state or local law regulahng construction or fhe <br /> pedormance ol cons'ruction. That I am authonzed by the owner o/fhis property to peAorm the <br /> �vork(or which application is made and!comply with!he Sfate Contractors La�v 18.27 RCW and <br /> 29u200 WAC. <br /> � U-�u w b'-n ,�, 10�� ��/� <br /> � Signawre Date <br />