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� , <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /a�/3�/� <br /> 425-257-8810 - FAX425-257-8857-www.everethva.org �-���2 ._.p�/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �! ���7 �n � �v A vP ��ere�tt 1 n�D�- <br /> PROJECT ADDRESS <br /> l_G�CoYVe ,� ��8 0 7 (.��� �l�fr/C F P,/'e� I,J <br /> Owner Mail Address � Clty � SUte2ip Phone <br /> �L3��'�v�\C` <br /> Tenant Mail Address Cily Stale/Zip Phone <br /> (3�0, 6�8— 276$ <br /> �Q � 1=C�1L 1-�, t7 �2?S?�17$ ki�a.S�2 1.1�s q��4� <br /> ElectricalConlractor MailAddress City `� Stale2ip Phone <br /> VA-t`�- F.�E� �i 16 R Co ��1�•� <br /> State License Number Cont ct Pdce of Work <br /> Proposed Uso of Building Contact Porson (Pinn Review) <br /> DescripUon of 1Nork lo Bo Dono: � //1 � � (�j i r/C O �/l S✓�L,� Ic� <br /> �I�c �,CS <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 {— p� \ <br /> 1 hereby certily fhat 1 have read and examined ff�is applica(ion and kro��fho seme to be frue end t � � I 2—Q O I <br /> correcL All provJsions oflaws and ordinar,ces goveming Oils type o(worir will be completed / i <br /> whefher specified.'oerein a noL Tho granting ol a pemuf does not resume to glve aufhonty(o <br /> violato or cance/tha provlsions o/any other sta�e or locallaw reguPting consfruction or fhe <br /> peHormance o(conslruction. 7'hat 1 am authonzed by fho owner o/thls property fo peNorm fhe <br /> work for whi�h applicntion!s mado and 1 comply�vifh tho Sfafe Confrac(ors Lew 18.27 RC W and <br /> 296.200 WAC. <br /> � � /Z�i 3/� <br /> Signaturo ate <br />