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EL�CTRlCAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVF_RETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> / �/l� /�r�'f�,� �.�� <br /> I PROJECT ADDRESS ' <br /> � <br /> C ^"�G'`` � f'7/�s /yLo Sz1�i� �� lt/�`�!�7a1 I�;� 29z-��i <br /> Owner <br /> Mail Address Ciry Sta /Zip Phone <br /> L�'�" <br /> � ' � � ��7� City p Phone <br /> /f Tenant � MailAddress State2i <br /> �- f1 �� .� �L� �iu�- h�1/��i�3 Z��-L33 �8�� <br /> .� Phone <br /> Electrical CoNractor Ma�l nddress <br /> Cny St elZip <br /> �7,'�L,, L)��/. � -y' ��'UI U'170.JU <br /> � Contracl Price o(Work <br /> State License umber <br /> C������� d�nf � <br /> " Contact Person (Plan Review) <br /> Proposeti Use of Building <br /> I,1 ery��� �� <br /> Description of JJork to Be Done: ��, �C� �Ll���� — �l`l�r e �1nt A S�L <br /> -� <br /> ' NOl'E: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �>t� <br /> ( �-75 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereGy certily fhai 1 have read and examined fhis applicafion and know the same lo Ge frue and _ V � <br /> co�recL All p!ovisions o/laws and adinances govemmg Ihis;7pe ol work will be completed 'rC I � �.iZ j <br /> whefher specJied herein or noL The granfing o!a pernuf does not presume fo qive aulhonty to <br /> violate or cancel fhe provisions ol any olher sfafe or local law regulafin9 conshuclion or(he <br /> peAormance o/consfruction. Thaf 1 am aufhorized by the owner o/this property to peAorm the <br /> work lor which applicat�n is made ar�d-lcpmply wifh the Stafe Conf�acfors Law 18.27 RCW and <br /> 296.200 WAC. � / / <br /> � -�;� <br /> r�� � �'��°''�� <br /> -Signature Dale <br /> J <br />