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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.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CAROS ARE NOT ACCEPTED <br /> / •"01 Wrjh7U:L rr/� ���hi'i i , W� <br /> PROJECT ADDRESS <br /> C4�tUZct� c;� Gvo ��1e1 i�e��c�-c �o �./�„e17 w� yglc�� 4zS2�(pGS <br /> Ownef Mail Address City State2ip Phone <br /> Tenanl Mail Addmss City State2ip Phone <br /> ��c, ��t�T�r-.� �'�v ��erzc•� wa �-�E�z�i A25 'ZSg�bG3 <br /> Electncal Contraclor Mail Address City Slate2ip Phone <br /> I <br /> iy��0�D0 � �'17 <br /> State License Number Contract Prico ol Work <br /> ui•.�rcua �Ne �c m �u�FAC�1�e�E <br /> Proposed Use of Buildinc� Conlacl Person (Plan Review) <br /> Description of Work�o Be Done: ��-�Y��Ju ��tiYV `H 7a � �h �`u V������ `Cfh�Y`'�"M`' <br /> I <br /> �V1f`1 �J�H ���"'l`�`RY�, . <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 CODE IS 3105 <br /> 1 hereby cerfily(haf 1 have read anA examined fhis applica(ion and know Ihe same fo be tn�e and <br /> correcl. All provisions ol/a�vs and ordinances governmg fhis type oI work will be complefed <br /> whelher specilied herein or noL The pranfing o/a permd does nol presunte lo give authority to <br /> violafe or cancel the provisions ol any other slate orlocal law regulatin�construcfion or the <br /> peAorrnance o!consfruction. That I am authorized 6y!he owner o/fhis property fo perlorm the <br /> work lor which applicafion is made and I contpfy wifh the Sfate Confractors Law 78.27 RCW and <br /> 296.200 lM1'AC. <br /> ` —, J <br /> , ,5�n 'r:,,t;,y��,'�:, ;�l` ' �'-'4-�2c�C� �G�O�l'133 <br /> � Sic�nawre , � Uale <br />