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ELECTRICAL PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 -i3--a9 <br /> 425-257-8810 - FAX425-257-8857 -wnvw.everettwa.org �aq03-066 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '' � / l ;�.. <br /> �' l, � , � , ,� <br /> PROJECT ADDRESS <br /> i <br /> "��- �� �� %l��-/ o�, � �; ��.�� �: <br /> ONner / Mail Address City State/Zip Phone <br /> Tenant MailAddress Ciry SWtelZip Phone <br /> /� F' �-- - <br /> Eleclricai Contraclor Mail Address Ciry State/Zip Phone <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Description o(Work lo�e Done' ��-�� � / GL� ���"�� l-s� V c'/ "7 7/ -2i /7`d✓ <br /> 1� l � f(�� '� ���' � i <br /> / / <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 5 — �j <br /> I he�eby ceitily thaf I have read mid examined this application and know the same fo be We and t=! i'��� � ��r <br /> correci. All provisions ol/aws and ordina��ces governinq Ihis fyp^oI�vork will be complefed � � <br /> whether spealied he�ein or not. The granlin�oI a permd does not presunte to give authonty lo <br /> violate or cancel the provisions olany ofher state orlocal la�v regu/ating con56ucfion or fhe <br /> pedamance o/construction. That 1 am aufhorized by fne o�vner ol fhis property tn perfomi fhe <br /> �vorh Ior which appfcation is made and 1 comply�vifh thc State Contractors La�v 13.27 RCIN and <br /> 29G200 WAC. <br /> / <br /> ;� � / � ,�,� ?, �/ ,S'._ GJ !, <br /> Simti�luir, � iJa�e <br />