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� <br /> ELECTRICAL PERMIT APPLICATfON <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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> � 36 31 �c��Q�.�,.v � U�- <br /> PROJECT ADDRESS <br /> OWner MailAddress City SWte2ip Phone <br /> Qu��.v�u � �31 �nu��� �� �u��- ln�� `/.Z4-132 <br /> Tenant Mail Address City Slate2ip Phone <br /> �jC:7-- <br /> dl9fv-el'.�v,v. � yW r �f� .So�� ��wy�Q�.nc�� 1,.�� �c�',73 �(2�(ezs <br /> Electrical Contr or Mail Address Ciry State2lp Phone <br /> ,ey-2J' S� c� ��C � �(xj� <br /> State Li nse Number Conlract Price of Work <br /> ���,� C, s��a� g� uc.�� �, <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Description of Work ta Be Done: I�S7�V�-� � �J� �� ��5 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce�:ily that I have read and examined fhis application and know Ihe same to be true and <br /> conect. All provisions of/aws and ordinances govern:ng th�s type oI worh will be completed <br /> whether specd�ed herein or not. The g�anting o(a permd does not presume to give authonty to <br /> violate or cance/the provisions of any other state or local/aw regu/ating consWction or fhe <br /> performance olconstructron. That/am aulhonzed by the owner ol this propeny fo pedorm the <br /> wak!oi which application is made and I comp/y with fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> G�-P-e-� �i� ��2 � �3-� Y <br /> SignaNre �ate <br /> � C f� - �C <br />