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( � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org ���3-09 <br /> APPLICATIONS ARE ACCEPTEU FROM 8 AM TO 4 PM ��O1 �D93 <br /> ' � ' z � p i � <br /> Pi�OJECT ADDRESS <br /> 2''6 ��i-��I <br /> f�-1�v,e � !^�,n_...1�vW�G,�, � 2►r St'Np� S fi I'�'�c ►,,.fl— 9�'�c�� <br /> wneb r - Mail Address City State2ip Phone <br /> ; ���,�f: �r V�o� I 16 3Z ��./e.qreE.,, l�w �'L.OT� U%� 41 r �r� ��i <br /> enant Mail Address City Staterzip Phone <br /> Pe.l _.S /9�'Oj I�w� -ri LYNNwUNc� LIA�T' 9�903�j (�iT'277a.a L <br /> Elec rical ontrauor Mall hddress City Slate2lp Phone <br /> '.�S �3 Q <br /> Stale �cense Number Contract Price of Work <br /> �� ���� <br /> Proposed Use of Building Contact Person Plan Review) <br /> Description of Work to Be Done: �����y�l `-P��S R'Yi �N�.�) <br /> NOTE: VViRING IN NUN-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ���O� <br /> 1 he�eby ceRi/}�that 1 have re2d and examined fhis appfication and know the same to be true and '� � <br /> correct. All provisions o/laws and ordinances governing this type of work will be completed <br /> whefher specified herein or not. The granting of a permit does not presurne to give authority to <br /> violate or cancel fiie provisions o(any other state or local law regulating construction or the <br /> performance o/construction. Thaf I am authorized by the owner o/this property to peNorm the <br /> work(or which application is made and 1 comply with fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �_�_:.S-���-_ /--L �-� <br /> Sigr•ature Date <br />