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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EV'ERETT PERMIT 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 <br /> i�I� �le��,'1 r" /y�- <br /> PROJECT ADDRESS <br /> IJe� Al/�� i9�srl�w'�}v� L-1 �✓emtf" I�/� 9g��J <br /> Owner Mail Address Cily State2ip Phone <br /> bc�lfi �IK�, �9�s Nc��,t�,q�e �� r��r��i� 98�01 ao6 ��q�q�o <br /> Tenanl Mail Address Ciry Slate/Zip Phone <br /> Electrical Contractor ��� Mail Address City SlatelZip Phone <br /> State License Number Conlract Pnce of Work <br /> �i zzar-'� <br /> Proposed Use o( uilding Contact Person (Pian Review) <br /> lr C <br /> Descnplion of Work to Be Dono: I�e fnI �L«p�'�9 S , ��xP� , r( �'1� �v <br /> T <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF FVERETT LOCAL SALES TAX CODE IS 3105 <br /> � !hereb�-certily thaf 1 have read and examined this application and know fhe same to be tnie and <br /> correct. All provisions o/la�vs and ordinances governmg fhis type ot work will 6e compleled <br /> �vhelher spec�6ed herein or noL The gran(ing of a pernat does not presume to give aufhonty to <br /> violnfe or cancel fhe provisions o/any olher stale orlocal law regulating construcfion or the <br /> peri�rmance c/consfruction. That I am auflionzed by the owner o/lhis property fo peAomi the <br /> worR Ior which plicafion is made and 1 compty with the State Contractors Law 18.27 RC W and <br /> 29G.200 WAC: <br /> � /- /v -o� <br /> ignaWre � Dale <br /> �� Gd �-� lb <br />