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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EV'ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> Ar'PLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��� �'" \ �uC.fG1`�PP t11 �l-� —V e,�e�� �1.�I'� -1 �`bzO�j <br /> PROJECT ADDRESS <br /> ��L �IQ ��1 e ���ra�eev� �,.�� �`���\-1- �..�A ��bzo3 <br /> Owner Mall Address� City State2lp Phone <br /> �a-�vle <br /> Tenant MailAddross City SlaleZp Phone <br /> K.C. ��e�r�.� i��;� 7��z� s+►� ��� U.w,���� �,� ��c� �rz5 <br /> Electrical Contractor Mall Address Cily Slale2ip P one <br /> �iti�,'- Ila� <br /> _K F�FTr��-�-�,�P � ►50� . �o <br /> Stale L(cense Number Contract Price of Work - <br /> G�OC��(H �-�T1��e.— l�V�f'1'l<1VIANC� <br /> Proposed Use of B ilding Conlact Person (Plan Review) <br /> Description of Work to Bo Qone: �1��j�Q��l "� �P.W � f:I��C1�'N� � Lb Y\T'f U� l <br /> � iAV��1�/lA C.\�P l��� "' ��P �C�.� IZnz.svt-, <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- � VUCo_ ��� <br /> I hereby certily lhat 1 havo read and examined fhis application and know(he samo to be true and '�l <br /> correct. All provislons o(laws and ordinances yuvernfng thls typo of work will bo complefed <br /> whether speci(ed herefn ornoL The grar.tin�of a pormd does no( rosume to give aulhonty fo <br /> violafe or cancel fhe provisions of any other state orlocal Inw regoPa(ing constroction or 1he <br /> pedormance ol constructlon. That 1 am authonzed by(he owner ol thls propeAy to pedorm fhe <br /> work/or wAlch appllcnlion!s mado and I comply wifh fhe Sfate C�ntractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �W�• �� C�iV'GJI'V \ (�y� �� <br /> SipnaNre Dale <br />