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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.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ;�J�J2S- c'_✓av��Ye� w�l �'Je��r+l ,�,J� �8ave� <br /> FitOJECT ADDRESS + <br /> i��� <br /> 10��1 �k�1� l� />-� e✓LV`�{'eear 4,G�7 �I/�v�-i�' w� T7 N YO / �q 'qr"`/' ![�. <br /> Owner Mail Address � City SWte2ip � Phone <br /> i� � 7 . <br /> Tenant Mail Address City Stale2ip Phone <br /> �o �e `s ►�o�te� �4-� 2Z 4st�, �I � tyMM�aod u�H �1.� _ <br /> Electrical Conlractor Maif Address ry Slate/Lip j�p �"30�3 <br /> � <br /> pol�eSPe 9 / �- ,j i� o � <br /> State License Num er —r Contract Price oi Work <br /> ����R tz?� � �'1 �I P�c�' k , <br /> Proposed Use oi Bwlding Contacf Person (Plan Review) <br /> Description oi Work to 6e Done: M(� �f �� 17 e Q S I Lt l " �2 (�eD�0.0 � (1�1�1 `e� ' <br /> NOTE: WIRING IN NON-DWELLiNGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC ORAC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have r d and examined this upplication and know the same fo be true and <br /> correct. All provisions o(la and ordinances goveming this fype ot work wi116e completed <br /> wheflier specified herein no. The granfing of a perm�t does not presume fo give aufhnrity fo <br /> violafe or cancel tlie Provi ion of any other state or local law reguleting constnrefion or the <br /> perfomiance of construct n. af I am authorized by the owner o�this property to peAorm the <br /> work lor which applicatio is rn de and!com with the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �` ' � I .z 7 1 2 m�`' 9 , <br /> Sign u � Dale <br /> g�� -i�� <br />