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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,everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM !AM TO 4 PM -DEBR 8 CREOR CARDS ME NOT ACCEPTED <br /> �/ aKo�'.� �� �� I � <br /> PROJECT ADDRES9�— <br /> � P.o,�c ,370� �,�i��'v �,v� 9s�i -a�? �'�s�.�s���a i <br /> Owner Mall Addreas City StaleTp plwry <br /> Tenanl Mail Addresa Ciry State2ip Wwne <br /> s�A�vo�� �D,B�,r�?1�f�.JA1`� > 9sa7� s�a�a� ati�c� <br /> Electflcal ConVactor Mall Addresa Clly State2lp hona <br /> �-�,c�c,C_'���53�oz /3. O� <br /> Stete License Number Contract rice of Work <br /> Proposed Use of Building Contact Peraon (Plan Review) <br /> Descriptlon of Work to Be Done: �J�.�,�.:tfv, �� /��� ��iJ �l�,GS ��j)�� <br /> � �n V ��it/.f . <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��� �� <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby certi/y that I have�ead end examined fhis eppOcatlon end know the seme fo be true end <br /> correcf. All�vovisions ol laws and ordinances govemmg fhis type ol work will be comp/eted <br /> whefher specified herein or not. The granting ol a permif does not resume fo glve eufhority to <br /> violafe or cancel the provisions o/any other sfate or locallaw reguPeting construct(on or fhe <br /> perlarmance o/construcfion. Thet I am euthorized by fhe owner o/this property to peAorm the <br /> work lor which application is made end l comply wifh fhe Stafe Contrectais Law 18.27 RCW end <br /> 296.200 WAC. <br /> � '� ���� ��J <br /> S nature Date <br /> �0503-C�52 <br />