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ELECTRICAL �'ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ;or �z <br /> i'(ll�� /''l'Fi7�iC�IG�!? ��//f.-- <br /> PROJECT ADDRESS <br /> � „ �G <br /> � //�a�N ��s �.,.e ��it L..� � /c�/S /77 ./�u[_ .q/c SilD• w�• 9�'z%o <br /> Owner Mail Address City State2ip Phone <br /> `�/"f� �ZS'Z/�-of/,�j _ <br /> Tenant M17ail Address City State2ip Phone <br /> `7�'/1'l�, <br /> Eleclrical Contraclor h7ai�nddress Ciry S�ate2ip Phone <br /> ���ru,�, �� L 97 Sa� <br /> Slate License Number Contract Price of Work <br /> ��2 <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> � /7 <br /> Descriplion of Work lo Ba Done: �-C'/L'� /,�G'u'"`�� �O L' <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 certily that I have read and examined this app/ication and know Ihe same to 6e true and <br /> conecl. All pruvisions olla�vs and ordinances goveming fhis rypo o!work will be complefed <br /> whefher spealied herein or not The,qranfin�o/n pernut does nof resume to give authonty to <br /> violafe or cancel fhe provisions olany other stafe or local law reguPtin�constniction or the <br /> performance o/constnicfion. That 1 am authoiized by fl�e o�ti�ner oI fhis property lo perfomi fhe <br /> ivork lor wHich application is made and 1 comply�vifh fhe Sfate Contractors La�v 18.27 RC W and <br /> 296.200 WAC. <br /> _ ; � ��,�� /� �S' o� <br /> Si�pa e °Dale <br /> � <br /> � � 7 <br />