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� �. <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SE�VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> �/`�1,2 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> G-"�za� �b� <br /> 3Bo9 ' t��-oa���•, <br /> PROJECT ADORESS � <br /> 4ZS <br /> �o-,� Z$Z9 tZ.�c�o.rA�� E��.c���A � Z01 339 3�3g <br /> Owner Mail Atltlress City Slate2ip Phone <br /> aao- <br /> 55 A ���,�z.5 E'.x..����z� E., ����.J{� °18Zo� 32.6�g <br /> Tenant Mail Adtlre s City SlatelZip Phone <br /> `` 425 - <br /> �c\' n�`�sc_t_.�r,�a��c+� lZ4�S ��u.rc.lT l� I� ��ZO� 355-5'S1 Z <br /> EleclricalConlractor MailAddress Cily SlatelZip Phone <br /> �ELZi�S�IIZL`L —��W��� <br /> Slale License Number Contract Price of Work <br /> �� ��t�L¢_ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �� , <br /> Description of Work lo Be Done: �"�� r a. ���rm �� �k0 a-��"` I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> ���� <br /> CITY OF EVEREtt LOCAL SALES TAX CODE IS 3105 • <br /> I here6y certily fhat 1 have read and examined this application and know the samo to be true and —� <br /> conecL All provisions o/laws and ordinancos govemmg tbis type oI work will bo cornp/efed �� �--U� - ��„� <br /> whother spealied herein or noL Tho gran(ing o/a ponnit does not presume to give authonty fo <br /> violafo or cancel tho provisions ol any othor stafe or local law regu/ating construchon or fhe <br /> perfonnance ol constniction. That 1 am autl�onzed by the owner o/tliis proporty to peAorm the <br /> work Ior which applicafion is made and I compty wdh fhe State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /-Z3-ZoIZ <br /> Signatur �� Date <br />