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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 'C <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � I , <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> ! 1 /04� E�er� �ee.� t,c��y r' C <br /> PROJECT ADDRESS-� <br /> E�xf��suy P�aptc�.��� �c.c. ��6��r R��kerA,� '*,a�, �rei+, �.Jll �ig� c <br /> Owner �-Me.il Address City StatelZip Phone <br /> L��'e 6,�Pericace �r�,�ql �(��� f !!Og �u�a9�ee.n �,J�T t�erGfl, �.l.i( �141�0`l� <br /> Tenant Mail Address City State2ip Phone <br /> �Tv /u�oa �,��5•,s�,�,�.,6 7Nc�(� Hu.r�(cso., }�t{ Fl�re++ ul� g'G.2o3 <br /> Elect�ical Coniractor Mail Address City Slate/Zip Phone <br /> 6cR(�Y.�lc�gsc.� � r,sng° <br /> State License Number Contract Price of Work <br /> �.�.t+uGJC•�o � lS� MLd J � � <br /> Proposed Use of Building Contad erson (Plan Review) <br /> Descriplion of Work to Be Done: S+��Q�� i��esna�/y— �r� I.Jct �� 5���1 �'•�'�G�( ca,.i CiC�aa.� (Ya(f'�Gy <br /> / � o� <br /> l[�tn LG'/lA�rt �7J ANwc:'1` QY Yk� t.:��L n� I�Sfar l�. <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 3705 <br /> 1 hereby certi/y fhat I have 2ad and examined this applicafion and know the same to be true and <br /> correct. All provisions o/laws and ordinances goveming thrs type o/work will 6e completed <br /> whether spea(ed herein or not. The granting ol a permd does notp resume to give authonty to <br /> violale or cancel fhe provisions o/any other state or local law reyulating construcfion or the <br /> peAomiance o/constn�c6on. That I am aufhorized by the owner o(this property to peAortn the <br /> work/or which applicafion is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��L�1��:=,�+�,'�� y I'C�r v�,r v �08' <br /> Si a ure Date <br /> �v.3 -/ � <br />