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ELECTRICAs. PERMIT APPLICATION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-25'-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '>�.`. �5�; .5�-� J/�; c:�N -S'� — ��.�' l���- CVr...1iz-c.�� <br /> F'ROJECT ADDRESS <br /> i�N<? f�.�.� C��uc� <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenanl Mail Address City Slale/J_ip Phene <br /> i-. �(�:Ci - <br /> /<e .a;�� .v1.�4.� :.� G-�• ��.z s�f,� G�•�dr;,.,,, c�.-�.. t••.�,-.d, ��� °�s::�i9 33l•-7•�7z <br /> , <br /> I Eleclrical Coniraclor Mail Address City Slate2ip Phone <br /> �Sf{��/'/1.���i` �I%/ ��� <br /> Slale License Number Contract Price uf Work <br /> %� <br /> i��:•s,d,,��,4�l lCt,.�,� /`� /LL. <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Drscription of Work to Cic Donc: �����2=c �+-� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR i�C CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat I have read and examined this app6calion and kno�v the sarne fo be true end <br /> correct. All provisions o//aws and ordinances�overnmg this fype oI work will be completed <br /> whefher speciGed hercin or not The�ranfin�ol a pernuf dues not resume lo give aulhonty lo <br /> violate or cancel the provisions o(any other sfate or locallaw reguPafing construation or fhe <br /> per!orniance o/cons(ruc6on. Thaf I arn authorized by Ihe o�vner c f this prope�ty fo p�r;orm flie <br /> work Ior�vhich application is made and I comply with fhe Sfate G.,nfractois Law 18.27 RC�I'and <br /> 296.200 WAC. <br /> lss L��_.:� j, iyr.t;$' <br /> �: ' Signalure Date � <br /> r�'s0�-p � z <br />