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� t <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 � ���-� w/�7' �v�.��,,/'fJ— <br /> PROJECT ADDRESS <br /> � 2oS�oNC� � �o� ����-D w.�o,r �v�.-� G✓/� Q� �o I <br /> Owner MallAddress City State/Zlp Phone <br /> �fl �"L � F3udqel 11��licc�ce <br /> Tenant Mali Address Cily State/Z�p Phone <br /> r21,�f he-o� <br /> Electrical ConUaclor Mail Address Ciry Stale/Zip Phone <br /> State License Number Contract Price or Work <br /> LISQ� ��'��I�a vtC� �'cc. �� <br /> Proposed se of Buildfng Contad Person (Plan Review) <br /> Descriplion of Work to Bo Done: 1��'�u �/(�[O �Q .A-c-'�' a S l �O W vo I i uae 1 <br /> NOTE: WIRING IN NOPJ-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 certify that I have reud and exemined this applicatlon and know the samo to be truo and � �Z�Z ' � <br /> correct. All provlslons of laws ond orrllnances goveming thls typo of work will 6e completed <br /> whefher specified homin or noL The granting o/a permd does nof�resume to give aufhonly to <br /> violete or cancel fhe provlsions of any other stafe or local law regulating construction or tho <br /> peNormance o!construclion. That 1 am aufhorized by fhe owner o/this property to perlorm the <br /> work lor whtch application is made and 1 compfy wifh fho State Contrsctors Law 18.27 RCW end <br /> 296.20 WAC. <br /> � � ���— �— �Z — � � <br /> Signature Date <br />