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� <br /> ELECTRICAL PERMIT APPLIC4TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /Z V�� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org /a �- <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> G-D��a-� �7 <br /> �5nc� New .�� f�ve_ <br /> PROJECT ADDRESS <br /> �e��ecSPn c{n�e�nr�5r_s .�7� �`� �� Q�c �� �vr�� lM`i/98ZOS��(2,�� �7�^I- GL�� <br /> OWner -� Mail Address :ity State2ip Phone <br /> (,l)n� � D,iv�o��un;-��rs �����i 7�2 `�5�' �c.v `4����wcuc� W�/9 ' (4.1� 77g-.21.� <br /> Tenanl �� h7ail AdCross Ily State/Zip Phone <br /> /77rn� �`/��-�faC /73�/ 5',�La1 l�� �Sn�„(�,,.n�` t��i� 482�0 (,�C���B- 267D <br /> ElectricalCon�ractor MailAddress Cily State2ip Phone <br /> r�� �f ir�l� 9�2 3,� .�U . 0�{�7. �" <br /> Stale License Number Contrect rice of Work <br /> Proposed Use of�uildin9 Conlact Person (Plan Review) <br /> Description of Work lo�c Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(}�that 16ave read and exarnined this applicafion and kno�v fhe same to be true and � ��lu Ol� <br /> ccnect All provisions ollaws and ordinances govemmg thls type ol work will be complefed <br /> whether spec�fied herein or not The granting oI a pemut does not prosume fo give authonty to <br /> violafe or cancel fhe �rovisions oI ary ofher state or local law regulafing constn�cfion or the <br /> perlomiance of cons�nm(ion. That I am authonzed by the o�rner oI fhis property to pedomi the <br /> work for�vhich applicafion is made and I comply with the State Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> `' '���i'����`_�' <br /> Sipnature Dale <br />