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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 /> .3Da s" �B--n��t�. � <br /> PROJECT ADDRESS <br /> C�vu.t- � ��.� �OO�` U/�nL4-�r .f,t.c.¢- C�it.�-QJc�� ��� 9 g 2 0� <br /> �`N� Mail Address City � State/Zip Phone <br /> ���J�� '_�.�t�� o�25 �'�--G-a-� l�-� ,�e�e-:�, C�� Z o� z�8 -8 7�7 <br /> Tenant Mail Address City State/Zip Phone <br /> �o��p�,-,Daz.�.�-�,,�. ��oo s. /3���.�, ,���Le,, l,c��9- � � I (� g <br /> Electrical Contra tor Maii Address City� State/Zip Phone <br /> �aL A- 1J PT 3 7 9 i(/o ��Q no <br /> State License Number Contract Price of Work <br /> (� ��Q�.�-- <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: A ci_ ��' ! �"-"�-�c� <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 /> I hereby certify that I have read and examined this application and know the same to be true and / � � r �� <br /> correct. All provisrons of laws and ordinances govern�ng this type of work will be completed �� W�"'+ 'IJLt�� <br /> whether spec�fied herein or not. The granting of a permit does not presume to give authonty to <br /> violafe or cance/the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of thrs property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � /(.p /D <br /> Si r te <br />