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( <br /> ELECTRICAL PERMIT APPI�ICATION <br /> CITY OF EVERETT PERMIT SERVICES � -�-�g -�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �/1J2,� Sy <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO J P�' <br /> 30��� ��.�� � <br /> PROJECT ADDRESS <br /> ��� � �,� � ��.�r- o� s �� :��.�m..� G�./ 30 � l <br /> nef Mail Address Cily State/Zip Phone <br /> /' 1- (��( v�z r � ��� (�� 71t S �.i t�.�� L.J- <br /> Tenant Mail Address City State2lp Phone <br /> S� L� <br /> EleCtrical Conlractor tilail Address City Slale/Zip Phone <br /> Stale Li�ense Number Contract Price ot Wark <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work ro Bo Done: �J i�r ,�n����f k UOY�Q pY105� 1b �DYV1 C Qu21"��e �_ <br /> --� <br /> / <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, A4C OR AC CABLE. r�� <br /> 1) <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r r ' <br /> I hereby certily that 1 have read and examined this appficafion end know fhe same to be We and F `I I '�— � 5 N <br /> correcl. All provisions ollaws and ordinancos govemrng this type o(work will be completed I <br /> e�hether specified herein or naL Tho granting o/a permd does not resume to give authonty fo � <br /> violate or cancel the provisions ol any otlter state or local law reguPating construchon or the <br /> performance o/construction. That 1 am authorized by fhe owner o/this�roperty to pe�form the <br /> work lor which application is made and 1 compty with the Stafe Contractors Law 18.27 RCW and <br /> 296.2 C. <br /> gnature Date <br />