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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 425-257-885% —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> �.S%C� /.�/'u»r'-f?::c.,-'-l� <br /> PROJECT ADDRESS <br /> Owner A1ail Address City State2lp Phone <br /> n <br /> ia <br /> ��,����cy /�Z�-v ����rs <br /> Tenanl Mail Address City Stale2lp Phone <br /> C c%�aT�S�:�r/S' /�G 7z���/ .✓��7s`�`ST i=T�",�•'� tr��- �5= y��o�d' �/z5'v,fS-'�G�;> <br /> 6leclrical CoNractor Mall Address Clry StalelZip Phone <br /> _ < '�� �� <br /> �''� �',� I=;i ,;Z 71'f� <br /> Slale License Number ConUacl Price of Work <br /> .-, <br /> �" �'�r i G <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work to De Dona: l/c��i ' - � " '-�S"'�7� L —'�' l',Lii���'-�-*"' c v' i�c� x,ii,-=-=� <br /> ' -��,�u�. Cc'��� S'TS � l��o r �I.!/C �/ 1 /.v-rr.r�,o--�� i[��.�u L.¢rra <br /> %" T' ��s,c� <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO F[E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> 1 her^by certily fhat 1 ha�e�ead and examined this applicnfion and know the same lo be fruo and <br /> correcL All piovisions ollaws and orr/inances goveming this fype o(u�ork will bo complofed <br /> whefher spcafied herein or noL The granfing oI a pemut does not �resume to give au(honty fo <br /> violafe or cancel the prnvisions ol any other stafe or local low regulating consWcfion or the <br /> perfomiance o/construction. Thnf I am authorized 6y fhQ owner o/Ihis property fo perfomi fhe <br /> work!or which applicafion is rriade and 1 comply�vifh tho Stafe Contractors Law 18.27 RC W and <br /> 29G.200 INAC. <br /> ._ � � <br /> �� � � , � ��/ /. v <br /> � %'���-�.,,, �'�� � p� <br /> �� SignaWre � , � �a / ��a�j,��'c(p <br /> � <br />