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Nov 29 OS 02:09p Honey Nightingale (425)774-5523 p 1 <br /> P �,�„���ELECTRICAL PERMiT APPLICATION <br /> �S � �, �,,,.� CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (�.,�, a 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> J`�i• <br /> ���� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��o o /�e�:/1 �ee,� /�r.�✓/�"y <br /> PROJECT ADDRESS <br /> �.l611�/i � � Q � � w2v�l <br /> Owne� aBAddress C�y Slale2lp Phone <br /> T � �a aa��-sE p�� c,/��z� v� yf���s"y <br /> Tenanl Maithddress Ciry SUte2ip P..ene <br /> � �io ��arnC �i' /I/�.r/�%� ���� ���71? o�v��bb2� <br /> ElectricalContraCtor MailAddress Ciry Stale2p Phone <br /> 1�i�l�T��� �c0 Q (p /� �l 9��. ao <br /> Slate License Number ; J Ccntrac Price of Work <br /> f ).�- ,�;,.� Gre�er�e.' <br /> / /Ai�l�Qp[�iru <br /> Prvpos Use oi Dmlding Ccnl;d Person (Plan Reviz•v) <br /> Oescription of Wak to Be Done: ��1"yrj�b` /��wl �� Si�/l.Y/7Y�5t'r'J/r�"� ' <br /> I � <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 /> ( 7 hemby aerli(y l�wf 1 have mad and e::amined this epplication and know the same fo be Vue aod <br /> wrrec� Af!provisicns o/laws ond oaluiances go�•eming fhis type of�rodc will be completed <br /> whoUier speci red fremin or not The granfing o/a permrt dces notp resume lo gn�e auGronry ro <br /> violafe or cancaf Ihe provisions o(any otlrer sYate or bcal law regula(irrg cvnstnKiion or fhe <br /> performan� o7canstr�ction. Thal f am aulhoired by U�e owne��ollhisWeperiy(o peAorm the <br /> wori:for�vhich appFcation is made and f comply with Ihe Sfafe Contractors La�v i8.27 RCW and <br /> 296.200 WAC. <br /> � � <br /> Signatur �18 <br /> } - : i i <br /> .� , �' ' -}�� <br />