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( � <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.everethva.org <br /> APPLICATIONS ARE ACGEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> _ �;� 3 �l .�J�'04.,•lww/ <br /> PROJECT ADDRESS <br /> �a�� �['.�'J' �7 ��c'i/�4 �'Of; �.3`7 ���c�P� , /-1 �J-5 _3/ 5 � <br /> Owner MallAddress City Sfate2lp Phone <br /> �t�U �/3<•� /C <br /> Tenant Mail Address City State/Zlp Phor,e <br /> l �U;t'.s��D�'!c I �INL/Yi C ,��^i, <br /> ElectricalContractor MaitAddress City State2lp Phonn <br /> r^f o r�t.ro � 7k� .20�) �.. <br /> tate License Number Contract Price of Work <br /> /c]Ot� �.+/� � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriptlonafWarktoBeDone: _ r�� ✓P�N�^�c �C �r,i� ,S�rc �P .� �'Pmo� e <br /> �11�^P 7`/0�^ �lG F �+-� �o j-,:� f <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 here6y ceRily that I have read and examined this application and know the same to 6e true and <br /> correct. All provisions o/la�vs and ordinances goveming fh�s type ol work will be completed <br /> whefher specified herein or not. The grenfing ol a permit does nof presume to give authon;y to <br /> violate or cancel the provisions o/any other stafe or local law regulatingpconsfruction or the <br /> wor�lr�%revh/ch ap�l,ca�tiCon�s�made sraid I complve�th fhe Stafe ContracfosPLawy18.2 RCW and <br /> 296.200 WAC. <br /> C��/�-�<•� s-�3 �s - <br /> Signalure Date <br /> �0503-oQI <br />