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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 425-257-8857—www.everettwa.o,g <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> lolr3o 1y�E 120�'-�-A , ��Ua�r� , Wr�,��2U3 <br /> PROJECT ADDRESS <br /> Sar2n T�R.aw����bE lsla3'D TV�� r2or+,� t_.v��'Tt— w�- �XZ� <br /> Ownel MailAdtlrass Ci�y S�ate2ip Phone <br /> SJ�2A- "CQcW2�RiDEa� 1��30 -rvt� rt�ao l:v�n-�rT u.�a � L�a <br /> TenBnt Mail Address City Stalel7ip Phone <br /> % �/ / ���� <br /> EIOCIriCBI ConlreCtOf Mail Address Cily StatefJip Phono <br /> State License Number Contract Prica of Work <br /> Norn� r2��ioENc� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: UP L��t�� l:�-rS-�-\C�L p I�N�L <br /> NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certi/y fhat 1 have read and examined this appliwtion and know the same lo Ge We and <br /> correcL All provisians ol/aws anA ordinances govemmg fhis rype ol work will be complefed <br /> whe(her spea6ed herein or noL The granfin�o/a pemuf does not resume fo give avfhonty fo <br /> violate or cancel fhe provisions olany ofher state or Iccal law reguP�ing conslrucfion or fhe <br /> peAomiance o/consfrucfion. That 1 am aufhonzed by fhe owner o(fhis pmperty to pedorm fhe <br /> work lor which applicati is made and 1 comply�vith the Slate Contracfors Law 7827 RCW and <br /> 296,2d0�WAC. <br /> j � i <br /> �. ,'—. <br /> � <br /> � i i � y �-�, �� lD U <br /> �. SlgnaWre - i \ Daie <br /> ,, ,��� �3 <br />