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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 425-257-8857 —www.everettwa.ory <br /> APPLICATIONS ARE ACC�PTED FROM 8 AM TO 4 PM 5 _ �y_ � • <br /> ��c7�� �vX� <br /> ��� � EJ�� , .�; �%� <br /> PROJECT ADDRESS <br /> Owner Mail Address City Slate2ip Phvne <br /> I J /•��p �C J <br /> Tenant Mail Address Cily StatelZip Phone <br /> �.Ss�� r.��E��F�:L �'�. �'� ti .�r'� 5,�� ��u�;� � r.�� �'���� �%1�-33Y ifs'� <br /> Eleclrical Con(raclor Mail Address City State/Zip Phone <br /> �sSoc. �Lo �'8�L /`/�; �3-� ``� <br /> Slate License Number Contract Price of Work <br /> ����a: r ��-�:�� .5�,,�/;�., ,�� s�-� <br /> Proposed Use of Buildinc� � Conlact Person (Plan Review) <br /> Description of Work to 8e Done: �Y'�-1 S��VT`t �t � •�N�.j ( ���U �'�y !'�� U� <br /> u�-; �- L�c,�-� �� <br /> � ( <br /> —� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heraby certi/}�that 1 have read and examined this applicafron and know the same to be true and <br /> correct. All previsions of laws and ordinances govemmg fh�s type of work will be complefed <br /> �vhefher spealied herein or not. The granting of a pernut does not resume to give authonty to <br /> violate or cancel fhe provisions of any other stafe or local law reguPting construction orthe <br /> performance ol construchon. Tha;1 am authonzed by the owner ol this property fo perfonn fhe <br /> �vork lor which applicafion is rnade and 1 comply wifh the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � l <br /> /' �/�'�4 �i. �� �'S��j%) � <br /> Si ature Date <br /> rc � c5 n�=c <br />