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l <br /> ELECTRICAL PERMIT APPLICATION ( <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �o� at,a ,�� <br /> PROJECT ADDRESS <br /> 1 G�.�-� i vQlSor� I D� I 1 � 33��` Q I S� Snc�10�YlIs� l,l?� r-I�C2�1 � <br /> Owne� Mail Address City StatelLp Phone <br /> Tenant 1Aa��Aaeress - Ciry SWte/Zip� , IzS� 33�pn;T`{ <br /> `�n���,orn�clr` �lec I���,�nc -�o�r��p �-1 K �n��crn,sl� v,��i�s2�i I <br /> ElecMcalConVacto� MailAddross City StalelDp Phone <br /> sn�oHo �.T' 1io �v�l Izao. o0 <br /> State License Number Contrad Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescripUon of Work lo Bo Done: fP-Q`dS2 T�LISG� �O� WI I Vl.� � ��-A'n'1Q �.��� <br /> bc���� �3�,Q.1 <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 /> 1 hereGy certify thot!have read and oxamined fhis applicafion and know fhe same to be tnie and EI W3- I�{� <br /> cortecl. All provisfons o/laws and ordinances govem�ng fhls typo ol work wi116e complefed <br /> whafher specified hemin ornoL The granfing of a pe�nd does not prtrsume fo give aufhonty to <br /> violate or cancel Uie provisions o(any other;tate or local!aw regulating consfrucfion or fhe <br /> peAomtanco o(consfrucfion. Thaf I am aufhor.'zed by the owner of this property to per/orm fhe <br /> worlc(or which application is mad3 and I comply wifh fhe Sfate Contractors Law 18.27 RC W and <br /> 296.20 AC. <br /> �.l.l� � 2.� �� <br /> gna Date <br />