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Sep 02 04 O�: OIa P• 1 <br /> ELECTRICAL PERMIT APPL�CATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www•everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �3io fa�` sT <br /> PROJECT ADDRESS <br /> 3�0 <br /> DE��3r� �v�s�ZT 13�0 ��� sj FV�i2ic� �F�� �-v9s <br /> Owner Mail Address City State/Lp P one <br /> Tenant Mail Address City StateZp Phone � <br /> y1S <br /> ��Ai��vF.� Sx� �4c� �cG��r�'�% �r/ l�c��/1rI� �f�o� .2r��✓4i <br /> Electrical ConU2ctar Mail Address C'iy Stale2p Phone <br /> 1z1��1K�d.rs rv.� c.�' <br /> Stale License Number Contract Price of Work <br /> propos�Use of Building Contact Person (Plar Review) <br /> Descr.p.ion af Work to Be Done: ��� !"���L �r'Z-S�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEc <br /> BE IN RACEWAYS, MC OR AC CABLE. �r b,� <br /> S <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y that 1 hare�ead and examined this appficab'on and know the same fo be we and <br /> correct. All provisions o/laws and oroinances goveming this type ol work�.vi(1 be compleied <br /> whether specrfied berein or no1. The granting o(a permd does notp resume fo give authoriry to <br /> vio(ate or cancel the provlsions cf any ofher state c�local law ragulatmg construcfion or the <br /> peAormance o(construUion. Thaf 1 am authorized by the owner of thrs p�opeRy to pedorm the <br /> work ter which application is made and f cemp/y wdh fhe Slate Contracrors Law 18.27RCW and <br /> 296.200 WAC. <br /> l Lo <br /> ignamre Date . <br /> F0904 -�/a- <br /> ��i'�i _ ; . - � <br />