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� <br /> ELECTRICAL PERMIT AP�LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, VJA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —vm�w.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> / <br /> 2 >�' `� ���1S0 �� �}�� � <br /> PROJECT ADDRESS <br /> :��ic��r�r/� � o/f�s�,, z 3Z y ��ksc•� .�'<.� L—���-� �5��3 `fz3�-3�as� �A�� <br /> Owne� Mail Address Cdy Slate/Zip Phone <br /> Tenanl <br /> Mail Address Cily SlatelZip P110°e II <br /> !� ✓`1�r3 '� �riGn.� .3U0��'!t'�> �itK �iftil/ Y�ZL'� yZl`'Z7/�'2 �4I � <br /> 1 !�t t✓ Phone �, <br /> Ele rical Conlraclor Mail Atldress Ciry State/Zip <br /> 1 <br /> i I <br /> /-' Yl-�/L�5 /�/ Z Gf� �DC'JC� � <br /> Slate Lir.ense Num6er � Conlracl Price of Work I <br /> ,�� � ��� �.�Y /f./� I <br /> Proposed Use o(3uilding Contac[Person (Plan Cieview) I <br /> i <br /> '`�ly-� �(/ � <br /> ✓` '�'�� rCC ��'C�rG �!-lY���a �!_ !-;�/� � 'l i/ �G ,��a' ,-� <br /> Description of Work to Be Done: � <br />•--. <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> i BE IN RACEWAYS, MC OR AC CABLE. <br /> � I <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> I he�eLy cerfi�y that!have read and examined fhis application and know the same to 6e We and ��.��-'� � �� <br /> Icouect. All piovisions ollaws and ordinances goveming Ihis type of work will be complefed <br /> �rhether specilied herein or not. The granting of a perrnd does not presume lo give authonty to <br /> �io!ate or cancel fhe provisions o/any olher state or local law regulafing construcGon or fhe <br /> Iporiormance o/construc6on. Thaf 1 am authcrized by the owner o/fhis propeRy fo peAorm the <br /> �•,ork for which application is made and I canpty with the Sfafe ConVactors Law 18.27 RCW and <br /> ��gr,p00 WAC. <br /> I � <br /> :,�`. �'/�:� �j- "7 - / 1 <br /> � �-� SignaWre Dale <br />