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ELECTF�ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER`JICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 12 I� F{z�yi /h�e�. `I�'l�I <br /> PROJECT ADDRESS <br /> �t����-�y l� U-ra�s �2iq li�,yl F1v�� t��c'rcti- I��l1 `��201 ��fZS�zSy-(o�lZ�i <br /> Owne� J Mail Address Gty Stale2lp Phone <br /> Tenanl Mall Address City Slale/Zip Phone <br /> OW�c`" <br /> Electrical Conlraclor Mail;.ddress City State/Zip Phona <br /> Stale License Number Contract Prico of Work <br /> �GS����,o.� <br /> Proposed Use of Building Conlact Porson (Plan Review) <br /> DescriptionofWorkloBoDone: �0^-�1_� ����C�` ` �`o`r ��"r'y— c�"1�--� rZS�CX�^C� _ <br /> � _o-_ l ( t/ I <br /> �J �<W �o..�s� l �G:�`IYGu�.— �.^('l� C� �.'IbSL�'�� . � ��1��1L'�' <br /> -�Yatvh�.,� c�—e Yv�-Q,II � G`t-G�'�`� cn.l �-'� ...q1 L'9-✓tfp�iC�lOh <br /> NOTE: WIRING IN P�ON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that I havo read nnd examined this applicafion and knmv Ihe saniu fo be true and <br /> correcL All provislons of laws ond on�inances goveming fhis fypo o!work wilf be complafed <br /> whether specified herein or noL i he granfinr�o(a pemut does not presume fo give authonty fo <br /> violafo or cancel fhe provisions ol any ofher stafe or local law re�ulating construction or the <br /> peilomiance o/conslrucfion. That 1 am aufhonzed by fhe o�rner o(Ihis property fo pedomi Iho <br /> work!or which applicafion is rnodo and I comply�vifh the State Confracfors Law 18.27 RCW and ^ <br /> 296.200 WAC. /1r) I� / <br /> C /1 1T sl�sl�� -� i� � <br /> Siynature �� \ Uate I-" <br /> v <br />