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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 425-257-6857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> y`d��Y .S�c.uvcQ .'�U� <br /> PROJECT ADDRESS <br /> ��,/,�,�.�.... �(r�f�' Y s�. ..�.c.( ia vs �c�c�-Q,II c�.-¢ Se�� <br /> Owner Mail Address Ciry SWte21p Phone <br /> Tenanl Mail Address City S�a�eZp Phorre <br /> 1�5,� �-��L 7�3 S'�s"� t=�. �..z� �.,� r g�.� �ss .s��,> <br /> Eleclrical Contractor Mail Address Cily SfatelZip Phone <br /> G�SoT�L �+-�0.2.z (� Z . / ��e. <br /> State License Number Contract Price of Work <br /> �C c5• -�-�_ <br /> Proposed Use of Bwidinq Contact Person (Plan Review) <br /> Description of Work to Be Done: S�vu( c` ���c�s.cy �7 " Z�(J Q� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEe <br /> 8E IN RACEWAYS, MC OR AC CABLE. dJ <br /> 55 <br /> CITY OF EVERETT LOCAL SALES 7AJ(CODE IS 3105 <br /> I hereby certily fhaf 1 have read and examined this application and know fhe same to be true and <br /> correct. All provisions ollaws and ordinences goveming this type o/work will be completed <br /> whefher specified herein or not. The granfing o/a permit does nof presume fo give authority to <br /> violate or cancel fhe provisions olany other sfate or local lew regulaling construction or the <br /> per/ormance o(construcfion. Thaf 1 am aufhorized by the owner ol fhis propeRy fo perform the <br /> work Ior which application is made and 1 comply with fhe State Contracfors Law f8.27 RCW and <br /> 296.200 WAC. <br /> dC .�C�C:y� __���.���_— �–I�-VS <br /> ignature // Dale <br /> E a5�7-D3(� <br />