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I <br /> ELECTRICAL PERMI�' APPLICATION <br /> CITY OF EVERETT PERIVIIT SERVICES <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> /53� /� ��T �vT <br /> PROJECT ADDRESS <br /> /QA�/ � ��-AN� /��AS�y yz5 zSg-en3 <br /> —� <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Atldress City State/Zip Ph..,r� <br /> /�/� C�i�c,T y F_�.CCTi2�< <`� i�l/� 5�.2s ZSz- 5�8 97 <br /> Electrical Contraclor � Mail Address City Stale/Zip Phone <br /> /LT CC�/NGL 00 3 NS <br /> State License Number Conlract Price of Work <br /> Proposed Use of Building Contact Person (Plan Re�-�ew) <br /> Description of Work lo Be Done: RLI,�J//1�= ��'S/��J`/N(� /-�aM�. <br /> �� z ae A. O/� 4,�V/CC <br /> NOTE: WIRING IN NON-DWELLINGS iS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> S"S�'0 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certify that I have read and examined this application and know the same to be frue and <br /> correct. All provisions o/laws and ordinances goveming this type of werk will ne completed <br /> whether specined herein or noL The granting of a permd does not presume to give authority to <br /> violate or cancel the provisions o(any other state or local law regulating consfrucfion or the <br /> pe�forman�e of construction. That I am aufhe�ized by the owner of this proper:y to pedorm the <br /> work for which application is made and I comph�w;;h fhe Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � z — �lo — OS <br /> S nature � Daie <br /> / <br /> ' Ec�s�a-o8�{ <br />