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ELECTRICAL PERMIT APPLICATION <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .��y ✓� /�Gif ��_-�0� <br /> PROJECT ADDRESS � ' <br /> � � � v ��� ` o�to�M�s� G�1 • 1�ozS� <br /> Ownef Mail Address City State/Zip Pho�e <br /> �'1�`�- ,�/y/�' /���c S� • �.L.� l.✓�•�'��o�r <br /> Tenanl Mail Address City Slale/Zip Phone <br /> �"pn��i �q �y.��dn/�c 17�-- ��(,�1' r.3� �00�/vlv',��C G✓l1"��7,- <br /> Electrical Co�actor Mail Address Cily State/Zip �Zr, G6Pho�OF/ <br /> QV <br /> ,������ j�',l/'oZB Z �DO ' <br /> State License Number Contract Price o(Work <br />� rt(p c (� �. H���. <br /> Proposed Use oi Building Contact Person (Plan Review) <br /> Descriptian of Work to Be Done: �% �{ �� fj � !�D/�C'E/��(� L,4s./ `O�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhal I have read and exantined fflis applicafion and know fhe same to be true and <br /> correct. All provisious o/laws and ordinances govemmg lhis type oI work will be comp/efed <br /> whether speafied herein or noL The granting o!a permit does nof resume fo give aufhority to <br /> violafe or cancel the provisions o(any ofher state or local law reguPting cunstruction or the <br /> performance o(wns(ruc6on. Thaf 1 am authonzed by fhe owner o(this property fo per/onn fhe <br /> work/oi�vhich application is made and 1 wrnply with the Sfate Contractors Law 18.27 RC W and <br /> 296.200 <br /> � <br /> i ature ate <br /> � ���j��� b Z°I <br />