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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S1 REET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425.257-8857 -www everettwaorg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 10-- 3i-i3 <br /> C- 13/0- gy <br /> I WO Bata 5f 54,,) mo rtes DV F <br /> PROJECT ADDRESS <br /> OwnerM <br /> pp nil Address Cay SlalelZrp Phone <br /> �OC� 11GiCf __PI'Da4Cdf sa�•+•-C <br /> Tenant Mail Address City State/Zip Phone <br /> Sx..+.PSs lrc . /� '�33 Q✓�4s L„tc�� Er lcrr# _ i,d4 I PLO <br /> Electrical Contractor Mail Address city Stale/Zip Phone <br /> o� <br /> &;&mc&S 876T9 $/200- 0 <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building p 1 Contact Person (Plan Review) <br /> Description of Work to Be Donn //y Ah�,2 <br /> I <br /> NOTE WIRING 1►r NON-DWELLINGS IS REQUIRED TO FEF <br /> BE IN RACEWAYS, MC OR AC CABLE. '- 3(�O <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ( b -- ' <br /> I hereby teddy that I have load and examined this application and know the sarne to be true and �I 31 <br /> correct, All provisions of laws and ordmances,goveming this type of work will be completed 1 <br /> whether specified herein or not. fie granting of a permit does not Presume to give authority to <br /> violatu or cancel the revisions of any o.her stale or local law regu/ehng construction or the <br /> performance of construction. That l am outhorizod by tho ownor of this ropody to perform the <br /> work far which application is made and I comply with Tho State Contlacfon;Low 19.27 RCW and <br /> 296.200 WAC. <br /> 3 'Ji i3- <br /> Signature ale <br />