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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98207 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 'a�'�O C��e��L 7 nr� IP ( '2V' �-��� <br /> PROJECT ADDRESS <br /> R'��Q-1'— ��C�n �YviC'�,',5 Llh �3Ca C1�Pnr�uYtr� J..u�'�—`1P.YC� "��u.� �7fA� �41.5�3`��- <br /> OWnef MailAddross City SIatGZip Phone <br /> �� �'� �� �/ // <br /> Tenant Mail Addmss Cily SWIe/Zip Phone <br /> �Yl�i�n\ 4-��1��c� 2221 C`�l;-�orn�a�-t / Ev r 4� �n�14 �1�2�\ (u75�L5t{ 3 � <br /> ElectncalContractor MailAddress Ciy SWte/Zip � Phone <br /> ��tJ �T E�.2ll N�1 �h Z�°1D .� <br /> State License Num6er Contract Prica of Work <br /> l�l�U,.�P����� L�,�.`� _ Wa.�.���� �tilz,n��� <br /> Proposed Use of Buiiding Contact P' on (Plan Review) <br /> Descnption of Work to Be Done: �`1S���QI\ 1 UI'1 (�T C�. IC� �(``'�[4 QQ <br /> sS�'_C_.l,l`(��l\ Sl\��P 1M • <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y fhat I have read and examined�his applicafion and know the same to be true and <br /> correce All provisions ollaws and ordinances goveming fhis type o!work will be completed <br /> whefherspecified herein ornoL The granting o/a permrt does not presume ro give aufhonry fo <br /> vio/ate or cancel the provisions ol any other state or local law regulahhg conshuction or the � <br /> performance of construct�on. That 1 am authonzed by the owner of this property to peAortn fhe / / <br /> �vo�k tor which application rc made and I comply with fhe State Contractors Law /8.27 RCW and � ���- � �/ <br /> 290.200 WAC. <br /> �- �, ���. � 05 <br /> � ignaNm Date <br />