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ELECT^ICAL PERMIT APF�"_ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROkI 8 AM TO 4 PM <br /> � �/� O � l�S <br /> PROJECT ADDRESS <br /> /V// (;�/ li-�� /� CI l � "�l Jc <br /> —�.� Phone <br /> Owner Atail Addre§ City Slale2ip <br /> Tenant Mail Address Ciry Slate2ip Phone <br /> ��e f', — <br /> Eleclrical Conlractor hlail nddiess City S�ate2�p Phone <br /> Slate License Nmnber Contract Price ot Work <br /> Proposed Use o(Building Cor,tacl Person (Plan Review) <br /> � n �,,� L/ / <br /> Descriplion of Work to Be Donc: �LIJ U `"�X 1 �'��'�� � e �� �'� �✓� r� ��T/7 � � <br /> �.�',YI D j11' ✓J'+'- � � <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 he�eby certil}�fh?f 1 have read and examined fhis c�pplication and knou�fhe same fo be true and <br /> correct All provisions ol lau�s and ordinances governing this type ol work will be completed <br /> whefher speciGad herein or noL The granlinc�oI e pemut does not resume fo give aufhonty fo <br /> violafe or cancel fhe r�rovisions o(any o0ier sfafe or local law reguPfing consfruction or fhe <br /> peAonnance o(consfruclion. That I am aulhorized,by the owner of th�s propeAy fo pedorm fhe <br /> u�ork lor�vhicb application is rnade and 1 cornpty wdh fhe Sfate Contractors Law 1 B.27 RCW and <br /> 296200 WAC. <br /> /' � �- <br /> ./��/ 6 � (��� <br /> �'./ut�'L�-, �✓`� ,.�.r�.,a /� //v�-3 , <br /> � SignaWre Dale /' ��\ <br /> V <br /> / <br />