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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-R857-ww�v.everettwa.org <br /> APPLICATIONS AP.E ACCEPTED FROM 8 AM TO 4 PM '3 �a-g �� <br /> �� � �— � tV11qIl.lY11= ���cIAI i.� <br /> PROJECT ADDRESS <br /> �.�4k� L���� l �u✓k tS �,-,c _ ?o• �� �'Y8 [-K- Sr�v�vi ; (�Z5$� <br /> Owner Mail Address City Slale2ip Phone <br /> �l23-3Si.� � 7C� � <br /> Tenent Mail Address Cily Slale2ip Phone <br /> Electrical Contractor Mail Address City Slate2ip Phone <br /> Stale License Number Contract Price of Work <br /> ,- . <br /> i—✓�- <br /> Proposed Use o(Buildinc� Conlacl Person (P�an Review) <br /> Gascription�f Work lo Be Done: � �=-m �' ��l�C�''� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> f3E IN RACEWAYS, MC OR AC CABLE. ;� <br /> � J <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read anAexamined this application and kno�v Ihe same to be Wc and <br /> conect. All prawsons of laws and ordinances govenung thu type ol�vork u�ill Ge completed <br /> whefher speaGed herein or not The c�ranfing o(a permR does not reswne to give aufhonty to <br /> violate or cancel Ihe provisions olany other state or lucal la�v ieguPling construcfion or the <br /> performance olcons(ruclion. That I am aufhorized by the owner ol this property fo pe�form fhe <br /> work Ior�ahich applicafion is made and I compty�vith the State Contracfors Law 1827 RCW and <br /> 296.200 WAC. <br /> �_ � L.W�.� 3/z� lo� <br /> Signature Dale i '�/��. <br /> C� ��� j`� <br />