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ELECTRICAL PERMIT APPLI�ATION <br /> CITY OF EVERETT PERMIT 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 �I ' � � �� <br /> � i7,Q�'`��� 5� <br /> Zz2y ��3cllv AN� <br /> PROJECT ADDRESS <br /> �=�se1�- N-'lltk IbHy /J 20��5�_ SG��cl;r� u�A '14135 Nts H79-ki2N <br /> Owner tdail Address Gry State2�N Phone <br /> Ten2n1 tdailAddress City Slate,Zip Phone <br /> O wN(/� _. <br /> Electrical Coniractor ldoll Addwss Cil� S�atc'Lp Pnone � <br /> Slate I_�cense Number Cantract Price of 4Vork <br /> Proposed Use o(Buildin� Contact Person (Plan Revicw) <br /> �M��V-/ <br /> Description o(Work to Be Done: �onr� l:wh� w..l� ow+�e.�Fs � d.r e!' a�r). w���* ti•aL'.,� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE'�'T LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceiiify fhat.'have read and ex.imined fhis application and kno�v fhe same to be true and <br /> conecL A!I provisiocs o/la�t-s and or�iinmiccs governmg fhis type oI u ork u-dl be completed <br /> whether specilied he��ein or not The granfing ot a perrnd does nol presunia fo give authority fo <br /> violate or cancel the crovisions ol any other state orlocal la�r re�tdaling consfrucfion or fhe <br /> perlornrance oI cnastricfion. That 1 am authorized by the o�sner o/this propert}�to perfonn the <br /> work lor which aoplicatron is made and I compty�rith fhe State Contracfors Lan� 18 27 RCW and <br /> 296.200 WAC. <br /> ! �� � _ O�1 - Z>- Zcny <br /> ��i�ature Date <br /> I - . .- .._ ._--- -- - --- <br />