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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 y�-�q�U <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> E 110 �l —0 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���- � Ca � i�or,+��h ��/� <br /> PROJECT ADDRESS <br /> C{�-4 ��' �()-P�ff'f <br /> Ow� Mall Address City StatefLip Phone <br /> I 1 � <br /> �/1 IIGS.F u�'Y <br /> Tenanl � Mail Address City Slate2ip Phone <br /> 36a <br /> I� �, 5�5�,�5�T'�cc. DogoK � g6 ��1�� w./�- �lb'.Z33 )srlssS <br /> Eleclrical Conlractor Mail Address City State2lp Phone <br /> n �s�Ss''� 987r� 6 �O o`v. 0O <br /> Stale Llcense Number Contracl Price o(Work <br /> �{J�n K0�"`�ui� <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Description of Work to Be Done: ni `����i�a�-�dq IA t �S-� i- W�rrS <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /� <br /> 1 hereby certify that I have read and examined this application and know the same fo be frue and �� � ��' � �-4 � <br /> cor�ect. All provislons of laws and ordinances goveming this fype ol work will be complefed <br /> whether speci�ed herein or not. The grenfing ol a permd does nof presume to give authority to <br /> violale or cancel the provisions o/any otlier state or local law regulating conshucfion or fhe <br /> perlormance o/construcfion. That 1 em authonzed by the owner o/thls property to peHorm the <br /> work lor which applicalion is mede and 1 comply wlfh tho State Contrectors Lew 78.27 RCW and <br /> 296.200 WAC. <br /> �;,,,, � �k y - i � - i I <br /> Signature Date <br />