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ELECTRICAL PERMIT AP6'LICATION <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 /> APPLI�ATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �-16 s � r"c�Es-r �R <br /> PROJECT ADDRESS <br /> I�"l�-�. ����� �� NS�- I ,N � <br /> Owne� Mail Address City Stale/Zip Phone <br /> Tenanl �dail Address City State/Zip Phone <br /> y25 �o$ S��j <br /> C,7!`f1!'��T ELE3:.��1G 62�3 �L6iStSr N,� j�tl�Wc1011 l�J� '�$Z.�2. <br /> EleClrical Conlraclor Mail Address City State/Zip phone <br /> C�rr.rr,I C� cx�o �� `� cjon� <br /> Stale License Number Contracl Price o(Work <br /> Sr R-- <br /> Proposed Use of Building Contact Person (Plan Review) <br /> // r7 F � <br /> Description of Work to Be Done: (..) �I�' !J�� Sr 1�— 7 s-X� ikM�1� J.'j �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> - I BE IN RACEWAYS, MC OR AC CABLE. <br />-�� , <br /> F <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�''� 1 here6y cerfily fhat I have read and examined fhis application and know fhe same to be true and <br /> conecL All provisions ol/aws and ordinances�ovemmg fhis type olwork will be cornplefed <br /> whefher speci��ed herein or noG 7he c�ranliny o!a penmt does not resume to give authority to <br /> violate or canc2l the provisions o/any ofher state or local law reguPting construct�on or the <br /> performance o/censtruction. That 1 am authonzed by fhe owner o/this property to perform the <br /> work for which application is made and I comply wilh the Sfafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �- � _'-- ^ <br /> S "�� OC� <br /> Signature Date <br /> (�-03 —I �'� <br /> '' .--� <br /> �-- <br /> _�-_ _,.-- — _ s�_ _...a,:-.��.� -,�� - <br />