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I � <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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> 3� <br /> -�!'0'� e.as t (�!► s :vW St-0. �v�.rcM w1�. 482oSf <br /> PR7JECT ADDRESS <br /> Evs.rvk+ lu�vctTw.�+� ir�a Ws�n� W�Mw� 2e� �ZVX 3�00 <br /> Owner MallAddress City SlatelZJp Phone <br /> se� • s�� • �s�t <br /> 1�t,�iUH Wiltivf3 375 A��w.r P�l�wriT 4�aif 'Y I Tyk-u•�1,��.I.A 4 Y1 9i1 <br /> Tenant Mail Address Clty State/7Jp Phone <br /> 60SfGsst�K�Tioesirrre�� vt-C c �rN�a ao P�eiClc w/. y➢e L8 �84; ' +Jf81 <br /> ElecMcal Contractor Mall AdAross Clty Swte2lp Phone <br /> t3e 55 ce S 97�-R�. (n� 000 <br /> State License Number Contract Pdce of Work <br /> Ca.cc S � +t- �CK So��Q�,or <br /> Proposed Use of Building Conlact Perzon (Plan Review) <br /> DescripUon of Work to Be Done: �!{�w 2Q� t�„p S.H-v 1 Cr �ip � C,v�( 5� t'� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAl(CODE 18 7105 <br /> I herehy certity that I heve read and exemined fhis applicatlon and know fhe same fo be frue end <br /> correcL All provisions ollaws and ordinances govemmg fhis type o/wudc Hill be completaG <br /> whethei spea�ad hers/n or not The granting ol a permd does nof�resume to give euthonty to <br /> wolete or cancel the provisians ol any ofher state or local law regulating consfructlon or fhe <br /> peAormance ol construction. That I am authonzed by the ownor o/fh�s propaKy fo peAorm the <br /> work lor which epp6catlon is made and I comply wdh fhe Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �'v�K �/a�.�.�-�f 9 • � 3 • ��{ <br /> Signalura Date <br /> r dKOq-o5S <br />