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� <br /> �/Tb"'Zs'1-8�'81 Sr+Soc��n� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-885" -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ) I � I I /��p0�.� �Z o • �5 LA,-,�� �,- zU I <br /> PROJECT ADDRESS <br /> � sz �E� w�-- 9� <br /> ,�1�]��rzN rua. I I(9 (� A�.oa� - <br /> Owner Mail Adtlress Gty . State2p Phone <br /> K25-�5�/-3z9� <br /> Te08nt Mail Aatlress Ciry Slale/Zip Phone <br /> �I ��IEd�sw- �0 .J4Nl:i �LM WM l.� a woo0 �t 808? ZU6 b')9-33/,3 <br /> non� c��Tscr <br /> Electrical Contractor � Mail Atldress Ciry StatelZip Phone <br /> 1�oM E-r5 � 993�-� <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Conlact?erson (Plan Review) <br /> Description of Nbrk lo Be Done� ����E' /�_� � `� � `�`�"� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> l�� s� � � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereDy ceRify that 1 have read and examined this application and know the same to be true and �c,�y- �4 3 <br /> conecL All provisions ol laws and ordinances govemmq fhis type of work will be completed C <br /> whether specilied herein or not. The granting o/a permR dces not presume to give authonty fo <br /> violate or cancel thc p�ovisions of any other state or local law regulating cronstn.r.tion or the <br /> � pedormance ol construction. That 1 am authonzed by the owner of this property fo perfo�m the <br /> work/oi which appliCation is made and I compty with fhe State Contractors Law 7827 RCW and <br /> 296200 WAC. ' <br /> Cf�, ` -- L� . 2'1 -O� <br /> Signature Dafe <br />