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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /�o/ `�l%G',�k'.//G�.erl ,��/ �/�,� � <br /> PROJECT ADDRESS � <br /> � � �� i9��/- -�� �� ���.�> > f'��3� �.,��,'�-ro - ���.� <br /> Owner Mai�Address iry StatelZip Phone <br /> Tenant Mail Address Cily State/Zip Phone <br /> � �D ' ' '� � /!r� /" f�a� ��.�01 Jh�Z �/i�c�'GJ �i'A,�nd�" 7.r'D.�� '7v�4-,�,� �/�� <br /> Eleclrical Contr ctor Mail Address City Slate2ip Phone <br /> �19C.(�NC i�o '�J G� �iao '= <br /> State License Number Contracl Price oi Work <br /> ,/ � N <br /> � �n.1� / �i df� <br /> Proposed Use o( uilding Contact Person (Plan Revie�y <br /> Description of Work to �e Done: _ ' � ed�me e �e �J �dE'� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��Up <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily that 1 have read and examined this applicafic�;and know the same fo be tn�e and <br /> conecL Al/provisions o/laws and ordinances governing fhis type ol work wil/be complefed <br /> whethei speafied herein or not The granfing of a pernut does nof presume to give authonty fo <br /> violate or cancel fhe provisions ol any other stafe or local la�v regulafing conshuction or fhe <br /> performance ol consf�uction. Thaf I am aufhorized by the owner oI fh�s property fo perform the <br /> work lor which applicafion is made and 1 comply wifh fhe Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �. J -` : //-/�DS� <br /> ignature Dale � <br /> `d5 �1 U� <br />