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( (� <br /> ELECTi21CAL PERMiT APPLICATION <br /> CI�Y OF EVERETT PERMIT SERVICES <br /> 3^OU CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLIC<�TI�iVS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �..�t.Q 16 <br /> ( �..13 \ �O gLc9.C�Q.V� �1J A�l G ioo 9--I aU <br /> PROJECT ADDRESS <br /> Owne� Mail Adc ress City State2ip Phone <br /> C�_ov�nu�nv.u«l.aZcc��ns� !- 7�u� �lawcdasa,� R� �.uornkl� l�.�A q�� 03 — <br /> Tenant Mail Address Cily Slate2ip Phr.ne <br /> ���Ou A��V e C,IQC��^« �v�e �O 6ox b-�� In�Y�wcx�c\W A q���_ <br /> Electrical Contractor Mail Address City Slate/Zip Phone <br /> NNOV r OSS \�C E i ��.�000. o0 <br /> State License Number Contract rice of Work <br /> ��ll� ll�Ul.\� V` <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work ta Be Done: �G SP11 l�lC Z � �JCAII�C1�` C\t'CIY��I�� QN\CJ� <br /> '�t��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWF,YS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I� `l <br /> l hereby certify thaf I have read and examined Ihis application and know the same to be frue and ����//' �2 V <br /> conect All provisions of laws and ordinances govem�ng this type o/work will 6e completed <br /> whether specdred herein or noL The granfing oI a permit does not presume to give authonty to <br /> violate or cancel the provisions o/any other state or local law regulating construcfion or the <br /> perfo�mance o/const�uction. That 1 am authorized 6y the owner of this property to perform the <br /> work/or which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � v�c�� �y . <br /> nature Da <br />