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( � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g-�� �� <br /> 425-257-8810 - FAX 425-257-3857-www.everettwa.org ��/d8.163 <br /> APPLICATIONS ARE ACCEPTED FROM 8 ANI TO 4 PM <br /> ��l�(0 /7 ✓/ /71�L <br /> PROJECT ADDRES <br /> /IL� GK TTGI/`d������ /�ii,� �V�2.2'� �� <br /> Owner MailAddress � City Sale2lp Phone <br /> Tenant Mail Address City Slale2ip Phone <br /> )��c.h Cll�r,� 1 L�- <br /> Eleclrical Conlractor Mail Address Gty Stale/Zip Phona <br /> S7'�/1��/-���� �. � S-C� <br /> Slate Liconse umber Contracl Pnce of Work <br /> �i,c LG l'<./l U <br /> Proposed Use of ilding Contact Person (Plan Review) <br /> i `, <br /> DescriplionofWorklaBeDane: �Q,6 ��✓� � f10 (Ll l[TC�J� T� <br /> NOTE: WIRING IN NON-DWGLLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC �ABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat 1 have read and examined fhis application and know the same to be true and <br /> correcL A/l provis(ons ollaws and ordinances goveming this type o(work will be completed � <br /> whether speci�ed herein or not The granfing of a pemut does not presume fo give aufhonty to � <br /> violafe or cancel the provisions ol any ofher sfate or local law regulafing consWcfron or the <br /> perfomiance o(cons(ruclion. That 1 am aulhonzed by tho owner of this property fo peAorm the � � I D� �I <br /> work for which application is mado and 1 compty with the State Contracfors Law 18.27 RC W and <br /> 296.200 <br /> �' �� �� <br /> Signature Da <br />