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� k -�,s -n6 <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 <br /> �� C'n i h�a A��'. <br /> PROJECT ADDRESS <br /> C'alh�i �a.li�Ur�niC� �/'�gell�vUPU.����5� �'�ll�v��� �r�2�� <br /> OWnef Mail Address City State2lp Phone <br /> ��ll�lE��' �17 �e <br /> Tenant MailAddress City State2ip Phooe <br /> �I�� 1yz—c�,:'s��. <br /> Q ���1�J ����'1"iC �G�15� l.''�"`�ST. S. I�✓ �A l u����YXx1� ��;�� <br /> ElectricalContractor MailAddress Ciry � Stale�2ip Phone <br /> �1��if�l('�����,i �' � �(1�i-, <br /> State License Number Conlrad f'nce of Work <br /> 7j��-(� �l�)��1/2'�l1 �, <br /> Proposed Use of Building �--� Contact Person (Plan Review) <br /> �escription of Woik ro Be Done: %�);��� �%1/���' ` ��' ' '��«�� �`''��r�� � �"�-�i� <br /> , <br /> <— �, T ��. `��=/? -' ``� �1.�x �7',�=,'� , ].��' <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�S 3105 <br /> I hweby certily fha(1 Ravo read and ezamined fhis applicafion and know Iha same to bo Wo and <br /> correct. All provisions ol laws and o�dinances govemmg fhis type ol worN will be completed <br /> wholher speci(ed heroin or noL Tho granting oI a permd docs not presume to give aufhonty fo <br /> violafe or cancel(he provisions ol any olher state orlocal law regulafing consWclion or fhe <br /> peAormance o(consfruc6on. That I am authonzed by the o�t-ner ol!his property(o pedorm fhe <br /> work lor�vhich app6calion is made and I comply�vifh the Slafe Contracfors Law 78.27 RCW and <br /> 296.200 WAC. <br /> , <br /> � '��� � .c,t�2/ �"/�l—G� <br /> Signalure Date <br /> /�'(.' �—�V / <br /> L` <br />