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t <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982U1 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 A'N T04 PM G � � ��-Dl'J <br /> C l�'�' <br /> ��,� M�NC vi C� fJ�.��C UN11'�' <br /> PROJECT ADDRESS <br /> L1� KC l.,i�,.�f� ►aornES <br /> Owner Mail Address Cily Slate2ip Phone <br /> Tenanl Mail Address City State2ip Phone <br /> `�25 3nB 5�5� <br /> �mMIT C�.F_c�121t. G2;�'�j 'L6lS-� ST N� S'flln�t�o��J wJ� �'�ti�'i2 <br /> Eleclricai Conlraclor A1ail Address City SWte2ip Phone <br /> �v M M 1 C � �6 ILZ, �J.a:,o <br /> Slate License Number Contracl Price of Work <br /> �re 5��2; <br /> Proposed Use o(Duildin� Contacl Person (Plan Review) <br /> Description of Work to Be Done: W I 1--1- J�)E � S�� � ��Mr �C�-U1C..� <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 /> 1 hereby certily fhat I have read and examined fhis application and knon the same fo be frue and <br /> correcL Flll provisions ollaws and ordinances governinc�fhis type ol work�vill be completed <br /> whether speci�ed herein aC noL The granfing ol a penmt does not resume fo give aufhonty to <br /> viola(e or cancel the provisions o(any ofher state orlocal la�r reguPting conslruction or the <br /> perionnance o(conslruction. That 1 am aufhorized b}�fhe o�ti�nerol this property fo perfonn the <br /> work for�rhich application is rnade and 1 cornply�vi(h the Stafe Conlradors Law 18.27 RCIN and <br /> 296.200 WAC. <br /> I��- � .— 6- ► `-I • o � <br /> Signalure Dale <br /> ECy(i�G(� -(o? <br />