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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES G-ag`�2 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everetiwa.org Lc, aob�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,/ S P�/ /''c7GK.L'—f—J=6(��71 �' Vi <br /> PROJECT ADDRESS <br /> /Jf�'i�% �'�. �;�`.^'-`'�� �c n r nn c.�C, i-V Lc�14 5/2s �s7-p2sv <br /> Owner Mail Address Clty Slate/Zip Phone <br /> Tenant A1ail Address City Slate/Zip Phone <br /> �1 i CC.E'_ ( �Zl C. �� (N <br /> Electrical Contract r Mail Address Clty Stale2ip Phone <br /> � ` C' �� �G`�Q ' � 1 Contract Price of Wark <br /> State Lfcense Number <br /> (' (— �'� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> /��r,�rcc.�= �= xscc �ic�6 ar��ri- �'� ..� . . .� <br /> Descriptfon of Work to Be Done: � ��-� � 5���� <br /> 1 N <br /> �, �C ��-M��l 1 �'1L1c�s� ^'� w �iS.c— <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE `o�1 <br /> dE IN RACEWAYS, MC OR AC CABLE. �D W <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> 1 hereby certify thaf 1 have read and examined this appfication and know the same to be We and �l ZQ� '" ` �QO <br /> conect. All provlsfons o(laws and ordinnnces goveming Uiis type oI work will be completed <br /> whefher specified herein or noL The granfing oI a parmit does not presume fo give aufhonty to <br /> violafe or cancel the provisions ol any other stafe or locol law regulating construcfion or the <br /> perfom�ance of consirucfion. That I am authorized 6y the owner o/this property to peAorm the <br /> work lor which application is made and 1 comply wifh the State Conhactors Law 18.27 RCW and <br /> 296.200 WAC. <br /> l - > � _ Z <br /> / � gna r . Date <br /> � <br />