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( � <br /> ELECTRICAL P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8&57—www.everettwa.org �1"2Z��� <br /> A P P L I C ATIONS ARE ACCEPTED FROM 6 AM TO 4 PM ���I� "�S9 <br /> �,�, ,-�-��- -�v� <br /> � <br /> PROJECT ADDRESS <br /> u z5 <br /> �, C.E�K l�l �1 i�zr.�Z cc'`�. P(-, ��1 t�vkt�T�G ��.vi 9�z7� y�c�a�-7G <br /> OWner Mail Atltlress City S�ate2ip Phone <br /> Tenant Mail Address City State2ip Phnne <br /> �r�— p� � �� <br /> ��1 ��—�L1lGIL ���17 �G 'CY �� �.I�LMC'�L/ CIVC�I/J4't�. 5 � <br /> ElectfiCal COntraCtof Mail Address City Slate/Zip Phone <br /> Z��f�:�e �`[ �fi� `� � 4-� , ao <br /> St le License Number Contrect Price of Work <br /> �-C�1 �,�CC— <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work to Be Done: ���`� � n�'S � � ��� �,`�" ` ��L•' C'� <br /> .��!��-I N�� l��- ����C� - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEC� <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRily thaf 1 have read and examined(his application and know the same to be true and � ��i <br /> conect All provisions o/laws and ordinances govemmg tliis type ol work wtll be,completed J <br /> whother speciGed herein or noL The 9ranting of a permd does not presume fo give authonry to <br /> violafe or cancel the provisions ol any other state or local law regulating conslruction or(he � <br /> per(ormance o/construchon. That 1 am authonzed by the ownei of this property to perlorm the � <br /> work/or which applicati n is made and I cnmply wdh the State Contractors Law 18.27 RCW and L � 11 - 15� <br /> 296.200 AC. <br /> �-C��- � 1f 1z1�f I <br /> Slgnalure � Date <br />