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--r <br /> ELECTRICA� PERMIT /�PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C�DAR STREET, EVERETT, V��A 98201 <br /> 425-257-8810 - FAX 425-257-5857 —•,vww.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 Ai!7 TO 4 PM <br /> f o315 I�f� �� <br /> PROJECT ADDRESS <br /> Owner Mail Address Ciq� State/Zip Phone <br /> �k j�►�y toziS 12� �� C✓e�t� W/1- <br /> Tenant Mail Address Cily Slate2ip Phone <br /> F�QE CoM r�t,�) �o � 3932 S�-rr�E wa RG2�( �aY s�oo <br /> Eleclrical Contractor Mail Address City S�atelZip Phone <br /> F,A�c�JL9gYr� � �34�80� <br /> Slate�icense Number Contracl Price of Work <br /> 1�. 6n17AL ��vtC_ [�STOP�/� C4w�E� <br /> Proposed Use o(Buildinc� Contacl Person (Plan Review) <br /> Description of Work to Be Done: INST�1l.L �/� l�6�lIGES /N T�. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> L_ 'z�� `� ° <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereGy certily that 1 have read and examined this npplication and know tl�e same to be true and <br /> correct. All provisions ollaws and ordinances goveming this type ol work will be completed <br /> whether spealied herein or noL The grantrng of.a permit does not presume fo give authority to <br /> violafe or cance/the provisrons ol any other stafe or local law regulating construction or the <br /> perlorrnance o/construciwn. That I am authorized by the owner of this propeRy�o perform fhe <br /> work lor which application is made and I compty wifh Ihe Stafe Confractors Law 7 8.27 RCW and <br /> 296.200 W� <br /> �-- alrl � <br /> Signature Date <br /> �o� - �, �,� � <br />