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(� . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �/ 9 2 Z r�el-� �� <br /> PROJECT ADDRESS <br /> T�n�, Lo� yy2z ��� V�� ��1 f �-n� 9�2�� ��6�7oyTl`u <br /> Owner Mail Addross City Slate/Zip � Phone <br /> Tenan� Mail Address Ciry Stale/Zip Phone <br /> f i�-�u�e�7Pc�Z IU y�s 5 n �C J.0 �2,f�P�1 l,� 9d"�l� ��21�'�-�'? <br /> Elecirical Conlraclo� Mail Address City Slale2ip Phone <br /> lNHavE.l' 952c � ySGG � �'° <br /> Stale License Number Contracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion oi Work to Be Done: 1�c w ��e I Q�Q J// �. �6�e <br /> NOTF: 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 3105 <br /> I hereby certily fhaf 1 frave read and examined this application and know the same to be true and <br /> correct All provisfons ollaws and ordinances goveming this type ol worlc will6e completed <br /> whether specified herein or noL The grantin�o/a pennd does not presume fo give authonty to <br /> violate or cancel fhe provisions o/any other stafe or local law regulafing construction or fho <br /> per(ormance o/construction. 7hat 1 am authonzed by the owner o/fhis property fo pedomi the <br /> work/or which applica(ion is mado and 1 cornply with the Stafe Contractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> � ��6/'O 4 <br /> 9 � > _ a� 7 <br /> SI nature � Date � <br /> Da-� <br />