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--( <br /> 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.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �.I.S/7/n �/pL/L/�'L. /n/-C � 3 <br /> PROJECT ADDRESS <br /> �� �f:�L o1..S^U G �l,e!�ran �-Q ��f/�� , ��c %4 �d� <br /> Owne� Mail Address Cily SWte2ip Phone <br /> I � O t <br /> TenBnl Mail Address City StalelZip Phone <br /> EQC 610� as'�Z ��� /�,��e �-3�z G—�►z��', �ua- Sk�� <br /> Electrical Contractor !.Sail Address City State2�p Phone <br /> �izG�L �i'�� c � / s� r� <br /> State License Number Contract Price of Work <br /> SFp E2 C�� -- <br /> Proposed Use of Building Contact Person (Plan Review) <br /> / / /�� r . <br /> Description oi Work to Be Done: l�(��A'2 /1�U7 � �ct,q —��Si�G� ���� (-"U t—��� <br /> �� u�P�P 2 ��zp !U�-� a/o � s Z <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEINAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certily that 1 have read and examined this application and know fhe same to be frue and <br /> correcL All provisions ollaws and ordinances goveming this type of work will 6e completed <br /> whefher speci�ed herein or not. The grantirg o!a permR does not presume to give aufhority to <br /> violate or cuncel fhe provisions o(any ofher sfate or local law regaleting construcfion or the <br /> peAomiance o/conslrucfion. That 1 am authorized by ihe owner of this propeAy to peAortn fhe <br /> work lor which appiication is made and 1 comply with the Sfate Contractors Lew 18.27 RCW and /�� <br /> 296.200 WAC. <br /> ��'�.� ,,�z6��a �-- ��l- <br /> �__SignaWre� Dale <br />