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( <br /> ELECTRICAL PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVICES � , �q `�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � �/0 5—�O 2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� � %) ��i/� r;i Z� � /� <br /> PROJECT ADDRESS <br /> I �'e ��G1 � L �c i?� 7'r- Z � � C` <br /> Owner Mail Address Ciry State/Zip Phone <br /> Tenant Mail Address City Stale/Zip Phone <br /> � � F �-P � � r3 .,� ��iz �2�u-�-�s l�� l� �,� � 4 kr� �/ <br /> Electrical Contrector Mail Address City State/Zip Phone <br /> -^-� 0 <br /> c <br /> � E �- � r �1 Yl � C' Z � l� /GOG_— <br /> State Liceose Number Contract Price of Work /�• <br /> { ,=1 R`t ���i C �f <br /> S//17o��. JC �4:W � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Work to Be Done: �'��- C� � �- — ZG e4 ��-, C �T .�- 7 — �� �� ��.� <br /> '� ��� �u �''� �.✓ � UD K} oc�,sn / Z G �70 �� �'��-� /�N-.� <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 certi(y that 1 have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances goveming this typs o(work will be cornplated <br /> whether spec�fied herein or noL The granting of a permd does not presumP[o yive authority to ,. <br /> violate or cancel the provisiens o/any other state or local law regulating construction or ihe '� <br /> pedormance ol constructwn. That I am authonzed by the owner o(fhis property to peAorm the � <br /> work lor which application is made and 1 comply with the State Contractors Law 18.27 RC W and , <br /> 296.200 WAC. � I(O b -1 p 2 <br /> :�/��� '�' ��--f/ <br /> Slgnature IJate <br />