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i <br /> ELECTRiC.�4L PER�VIIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SER�ICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 � FAX 425-257-8857 —www.everettwa.org / Z—a7—D'7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 A.M TO 4 PM C—07/Z-1 S3 <br /> Iv "55� i �( �v� sE <br /> PROJECT ADDRESS <br /> �_� � ��c f o � nx ���� � /�icccn� �r� U� ���� 1 U�s ��-33 �. �l <br /> Uwne� Mail Address Cily Slate2ip Phone <br /> Tenant Mail Address City SlatelZip Phone <br /> �_) � /v ��5� <br /> Eleclrical Contractor Mail Address City Slale2ip Phone <br /> 1 G 6s <br /> Slate License Number Contract Price of Work I <br /> Proposed Use of Building Contacl Person (Flan Review) <br /> Description oi Work to Be Done: (� L�`�S � � 'n ��6 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OFi AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and examined fhis application and know fhe same to be Vue and <br /> correcf. All provisia�s ol laws and crdinances governing tb�s type o(wo�k will be completed <br /> whether specdied herein or noL ThE granting o�a permrt does noi presume fo give au07ority to <br /> violate or cancel the provisions oI any other state or local law regulating consfruchon o�fhe <br /> perlormance o/construchon. That 1 am authorized,6y:he owner o/this property to pe,�(orm the <br /> work lor which application is rnade and 1 comply��:!h the Sfafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � � <br /> _��, �,, l f� - 't� —��}' <br /> SignaWre Dale <br /> ��., �a- i53 <br />