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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � Z�z1 _�� <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 /> /50% ,��~'`�� <br /> PROJECT ADDRESS <br /> %�'�,� � .��5/ /�c' /3'u /97Y Gii�'� i,�� 9��c�6 y<zs�s'o �-»> <br /> Owner � Mail Address City Stale/Zip Pnone <br /> Tenant Mail Address City Stale2ip Phone <br /> d w,�� <br /> Elec!rical Contractor Mail address City State2ip Phone <br /> r/Q"ZTD <br /> Slale License Number Contracl Price of Work <br /> /'�,,., -1�_/� i;'�i� L��„-, �i ; <br /> Proposed Use of Bui�ding Contact Person (Plan Review) <br /> Description of Work lo�e Done: ��f� '� �'f'• �' � �� '�`' —f�S�S <br /> �� C/l�GYi > AdC�'ti'av�.�/ E'�Yt'f/�'ee./ -�uy �i"✓.�.�� fi'�e .� <br /> i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> � CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 L W I I �J — Uv 3 <br /> 1 hereby certily fhaf I have read and examined this application and know the sama to 6e true and <br /> correcL All provisions ol laws and ordinances goveming this type of work will be completed <br /> whefher specified herein or noL The granting ol a permit does not�resume to give aufhority to <br /> violate or cancel tho provisions o/any other sfate or local law regulating construction or the <br /> periormance of construction. That l am authonzed 6y the own��,ot fhis property to perform the <br /> �vork/or whicl;application is made and I compty with the State -onfractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> � <br /> ��� ��i �/ .?z -// <br /> SigiSature � ' Dale <br />