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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ��_ ag -�O <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org �/�//�c3� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2�:�r Rv Lkt 2 t�.1� <br /> PROJECT ADDRESS <br /> �'�.�'T't- P�p �/�.(NS �31'S�,.,I�� �'" ��sR� 'IT 2S� =� 1�} � <br /> Owner Mail Address � Ciry StatelZlp Phona <br /> Tenanl Mail Address City Slate/7Jp Phone <br /> �A+SS 1� ��C� P �' (boy. �� �V��7't , �2C.Yo �}ZS � <br /> ElecMcal Contractor Mail Address City SWte21p Phone <br /> 1(�o�«E�1 �-�2v � �o� <br /> Stale License Number Contracl Price oti Work <br /> �E"`'P�1 (.._ <br /> Proposed Use ot Building Contacl Person (Plan Review) <br /> Descripllon of Work to Bo Done: K-rn��.+`"�� F�� �� w�a�`� �� <br /> SI�,--CiRc,J 1�'S i-o�. N�v.t 5�2��.C�r�I'r <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> � 11��1 - I <br /> 1 hereby certily thaf 1 have read end exemined this epplication end know fhe same to be frue end V �J 9 <br /> correct. All provisions o/laws and ordinences goveming this type of work will be completeE <br /> whefher specifled herein or not. The granfing of a permit does not Fresume to give authonry to <br /> violate or cance/the provisions o(any other state or locel law regulnting construction or tha <br /> perlormance oI construction. That 1 am authaized by the owner o/this property fo perform fha <br /> ivork lor which application!s made and 1 comply w'�th fhe Sfafe Confracfors Law 18.27 RCW and <br /> 296.200 y�4C. <br /> I �- i l /ZS / CS <br /> —Signature a a <br />