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--� �� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-0857-www.everettwa.org . <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 22z:3 ^..lerc.lc+�•al ,¢�-:. F,,..cuitf W.4 qYtCy► <br /> PROJECT AD�RESS <br /> Q�a l Es+a hc 81�ss�.� ��c. Y4 i s ���°``P� �E Kir�l.�.o� u/� �U�3 <br /> Owner Ma Addieas City State/7Jp Phone <br /> yZs SrZt- sy�r y <br /> No►-,,�. <br /> Tenant Mail Addreea � City Slate/Zlp Phone <br /> ��I �Sa/ ���'c�r,�:� C �� C �' 3�z � i f�f� ,L scJ c y�v,��aJ�K��/!✓.1 �� <br /> Elecldcal Conlractar Mail Addiees Clty State2lp Phone <br /> , o(p aG(e--t3s,�-yo�j <br /> ` i S z/�'5�,,��rJ '�'� �' - �.�cwv,o 0 <br /> State License Number Contrect PAce of Work <br /> �1 �f�/SE, �%/M �cCUSO,�/ <br /> Proposed Use of Buj Ing Contact Peraon (Plan Review) <br /> Descriplion af Work to Be Done: N�� ����<< ��NE � /��[�/NE" Ttl� � /Lu.�c� ,L../ /1�� <br /> �(/-lJ iJr ��� � � ��r,.,. y� i-�.� /�,ss� �co c��-:. , , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE 13�105 <br /> I hereby certity that 1 have read and examined this applicatlon and know the same fo be frue and <br /> correct. All provisions ol laws and ordinances goveming this fype ol work will be campleted <br /> whether specified here/n or noL The granting ol a parmrt does notp resuma to plve authonty ro <br /> violafe or cancel the provisions ol any other sfafe or local law regu/eting constructfon or the <br /> peAormance ol consfruction. Thet I am euthonzed by the owner o/this property to peAorm the <br /> work lor which npplication is made and I comply wifh the Sfate Contracrors Law f 8.27 RCW end <br /> 296.200 WAC. <br /> �. . <br /> � _ /�"�. �� . <br /> ' naWre �� Date <br /> /' <br /> � EaSoi -� �q <br />