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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ` O"L n <br /> PROJECT ADDRE <br /> ��b��(� s �zo� r�'�/� ,,Q � �- ��—c,.�� <br /> Owner Mall Address City State/Zip Phone <br /> �.,, �uc.(V �-E.Zvt �-��ie �e-�-�c ��� <br /> Tenanl Mail Address City Stale/Zip Phone <br /> �,��\d� �r�� ?'�(� S . I I �f" S�— �p>�}k(� (� `'IXICsd' lo(�zd(� � <br /> Electrical Conlractor Mail Address City-, State2ip Phone <br /> (I� -3 0-06 <br /> �l :e:�a� � I`�qT� � l�oo <br /> Slate License Number Conlract Price of Work <br /> ��"W��C� � . � , �.,lh fc. �,�f �) . <br /> �J�+., <br /> P:oposed Use of Building Conlacl Person (Plan Review) <br /> DescriplionofWorktoDeDone: �16 � ft���.� h V��,e�'� t-oc.,•�O <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 3t05 <br /> I hereby cetti(y fhat 1 have read snd examined lhis application and knuw fhe same fo be true and <br /> correct. All provisions o(laws and ordinances goveming fhis type of work will be completed <br /> whefher specified herein or noL The granting o/a pemuf does not presu�me to give authonty to <br /> violate or cancel the�rovisions of any ofher state or/ocal iaw reyuleting consfruction or the <br /> perfom�ance o/consfruction. Thzt I am authonzed by the owner of fhis property fo pefform the <br /> work lor which applicafion rs made and 1 comply with the State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � a <br /> ipnalure Dat <br /> jOG; - /� 3 <br />