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� <br /> ELECTRICAL PERMIT APPLIGATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-@857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> Z6l y Col�y <br /> �. <br /> PROJECT ADDRESS <br /> / ('� n �� Q,/��•�9 ��r,�Jy {�c/c�. � ` J�j ,�'rklti /K(' �'1//� �Q4� ���'� <br /> Owner � all A dress City Statetip Pi�one <br /> .1�rler;o�x <br /> Tenant Maii Address Ctry Stale/Zip Phone <br /> GSB Flec��'c /.GS3/ 80��Ai/� N w Stti�u/oo� l,d�Q 9�z9'z 3Ga�Sz�.�Ya <br /> Eleclrical Conlractor Mz�l?ddress Clly State/Zip Phone <br /> Gsa���� �.�3 �r � �oo �- <br /> Stale License Number Conlract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: �����r/ N�N� �p 7� T��T w res / n C�� l.�9 <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 IS 3105 <br /> 1 hereby certily that 1 have read and examined this application and know fhe same fo be frue and <br /> correcf. All provisions of laws and ordinances governing this type o/work will be completed <br /> whefher specdied herein or noL The granting o/a permit does not presume to give authonty to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> perlormance o/construction. That 1 am authorized by the owner o/th�s property to per/orm the <br /> work lor which applicafion is made and I co ply with the Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> .,��- � `1��� 7/.�_o� <br /> � ignature Date <br /> E0�{Ol -GYv7 <br />