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r <br /> i <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.everetlwa.org <br /> APPLICAT��NS ARE ACCEPTED FROM 8 AM TO 4 PM � ._� I -O �7 <br /> � L��J L K G-(?L"L'.1/ iJ A Y <br /> � 80 � �i' ������ /o� <br /> PROJECTADDRESS <br /> Owner Mail Address City State2ip Phone <br /> C`T(� 1�1/U�55 ��U��� /7W y�� �U�rC �` �,(�i.� ��ZO G <br /> Tenant MailAddress City Stale�2ip Phone <br /> D • C �cc-fri�lHc- CJ0�3 ���-/���� �AoKo.,,3� �J,1]- Q829G �Ga-(sG3'� <br /> Electrical Contractor Mail Address City StatelZip Phone <br /> 2�C1c9U <br /> Stale License Number Contracl Price of Work <br /> �I�i � }pa ct ����.....� LCG-+,�+�s— <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Dane: /�{d.Y- 19�,-,,. �i?n��` `� � G-.� � ���P�D4z.��S' ` �Z_� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfily that I have read and examined this application and know the same to be true and <br /> correct. All provisions o/laws and ordinances goveming this type of work will be completed <br /> whefher specified herein or noL The granting ol a permd does notp resume to give authonty to <br /> violate or cancel the provisions of any other state or/ocal faw 2gu/ating constructior. or the <br /> peAormance ol construc(ion. Tbat 1 am aufho�ized by the owner o(this properfy fo peAorm 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 /> j' �// /� � �� ` � � � <br /> Signature Date � <br />