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r <br /> ELECTRICAL P�RMIT APPLICATIaN <br /> CITY OF EVERETT PERMIT SERVICES ��g_�b <br /> 3200 CEDAR STREET, EVERETf, WA 98201 9 �./�� yoa7 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettw.i.or <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 3��s ��� <br /> PROJECT MDRESS <br /> �.Y��►�;��r 9i�m v�f.�F�u� Av� M�i � E►r� 9Szo� <br /> p�y�ef Mall Address City State/Zip Phone <br /> Tenant Mall Address Clty State!!Jp Phone <br /> �-`�� �aP.�c, Ifc�O � I�PItJV1U� �MWD eU �►�.�'1P1JJ�t.�� Wk �I2 4?�•�ob�4AD <br /> Eleclrical Conlrector Mall Address Clry Sfale2lp Phone <br /> 1)F�`05� � � I�,Q00 <br /> State License Number Contract Price of WorF. <br /> �"'"'��� Contact Person (Plan Review) <br /> Proposed Use o(Building <br /> i <br /> Descriptlon of Work lo Be Done: <br /> piyp l�UplTS 11� -NEW .�dll� 3°9"6 ��,f�g <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> I hereby certity thaf 1 have read end ezamined this application and know the same to be frue and <br /> correcf. All provisions ollaws and ordinances goveming thls type o(work will be complefed <br /> whether specified lierein or not. The granting ol a permif does not presume fo glve authority to <br /> viclate or cance/theI�rovisions o/any other state or local law regulaUng conshucfion or the oO� 0 y�I <br /> peAomiance o/construction. Thaf 1 am authorized by the owner o/this propeRy to perfortn the / <br /> work for which application!s made and 1 comply wifh the State Contractors Lew 18.27 RCW and i <br /> 296.200 WAC. <br /> � 7 � � � <br /> ignature a�e /1/1 <br /> �i <br />