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ELECTRICAL P I ATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FA`�425-257-8857 —www.everettwa.org <br /> APPLIf,pTIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> LQ+ � � us�o ��� �� s� <br /> PROJECT ADDRESS <br /> 2� � ��., (� G�k <br /> Owne� Mail Address Cily Slate/Zip phone <br /> Tenant Mail Address City Stale/Zip Phone <br /> ��P u�r� U��.��( fL �e� `Ct2'��� ��QQ✓ �M �liee.levt� �c� �� L (� <br /> Eleclrical Conlreclor Mail Address Ciry Stale/Zip Phone <br /> V�( Ui�l �ti� �i�� (�11�( <br /> Slat License Nurnber Contract Price of Work <br /> �-�'�i1�11�G � <br /> Propo d Use of Building Contact Person (Plan Review) <br /> Description o(Work to Be Done: __ ' " e�� ���1�'� �'U�( �G4C, <br /> NOTE: WIRING IN NON-DWELLINGS IS RFQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. s� c� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I 1 he�eby certify(hat I have read and examined fhis application and know the same to be true and <br /> correcf. All p�ovisinns olla�vs and ordinances�overnmg tbis type o/work will be completed <br /> whether speci6ed herein or noL The c�ranting oI a perrnit does nof presume to give authonty to <br /> violate or cancel fhe provisions ol any other stafe or Incal law regulafing construction or the <br /> peAormance ol construchon. That I arn au(horized by the owner o/fhis property to perlorm the <br /> work lor�ahich ap licafion is rnade and 1 compty with fhe State Contractors Law 18.27 RCW and <br /> 29ti.200 WAC. / <br /> � � <br /> ; , /lo <br /> / ig ture � .____ Date <br /> �� �-7-c�3� <br />