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cLECTl�iCA,L PERMIT APPLICATION <br /> CITY OF EVERETT �ERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX �25-257-8857 —www.everettwa.org <br /> /Z — �7—G� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> . [ O 7� Z —0`�-G <br /> �7 3��`"� �'—fi�r�'.. c�;�� ���vL <br /> PROJECT ADDRESS <br /> �� ,�j _ <br /> Owner AtailAtldn.ss Ciry Stale2ip Phone <br /> Tenant Adail Address City State2ip Phone <br /> Y �r�-E�.' �`_,�l�� �1`�l � _ <br /> Elecirical Conlrador Afail Address City State2ip Phone <br /> :� �(1L�1 �L i`' � C�' 7� � �� �jQ��c� — <br /> State License Number � Conlract Price o(Work <br /> � t^��O 5 <br /> Proposed Use of Buildinc� Contact Person (Plan Review) <br /> Description of Work lo Be Done: ��i=( �1 �� l_ `"`� "��-�G �,(,�.f� '� �-C3t+ti f L�'L� _ <br /> ;� All��LlJ ��o rJ�f <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 CO�E IS 3105 <br /> I hereby certi(y that!have read and exarnined this applicalion anAknore the same!o be frue and <br /> correcL All provisions o!/a�vs and ordinances govermng this type oI nnrk�rill be cornpleted <br /> whetherspeci(ied herein ornof. The granliny o/a permit does nof resume to give aufhonfy to <br /> violate or cancel the��ovisions ol any ofhar stafe or local la�v reguPfing construction or fhe <br /> peAermance o/canstrucfion. Thaf 1 ant authorized by fhe owr�er o�fhis property to perlorm the <br /> wo�k(or which applicafion is made and I comply�vith the Sfafe Confractors Lau� 18.27 RCW and <br /> 29G.200 WAC. .� <br /> � � <br /> . ,. � �� ��l ������� � `' ._� ��- � � — <br /> Si9nature � Dale <br /> l <br /> � � � .. <br /> _ <br />