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, - <br /> ELECTRICAL PERMIT ARPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �`-I6" I� <br /> 425-257-8810 - FAX 425-257-8857—www.evereltwa.org C.��D Q���� l <br /> �,' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �3� �'� ��;a�� � <br /> PROJECT ADDRESS <br /> T�srry � _l sa�. 3S��( 1=Q-.�`} ,� �v�.ra-7�- c�,,�-�1Fs� f `loz - 8 z t � 503 <br /> Owner Mall Address Gly State2lp � Phone <br /> Tenant Mail Address City Stale/Zip Phone <br /> �'e�-s��. ��-'�o,c � 2z�a.A�-.�.�s.4� �.,��- e.���a3 �zs-z4a-7 .� <br /> ElectricalContractor PAallAddress City State2lp Phone <br /> �� C-S (`�� � 83 � M} <br /> Stale Ucense Number Cantract Price of Work <br /> .� � �� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion of Work lo Be Done: 1��p�m- �z 5 f} Sn-�v��2 ��s�-�l a�to.�-S J� g.�tad �^�+� <br /> ��ns��l .N� t J�4-s G�- � A�-�- c 6�'T� ��s'fa-�I v�oc+�c ��.��. <br /> c.�.--L 'CV C-��ck��-s <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 6E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF cVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that/have read and examined this application and know fhe same fo be hue and <br /> conect. All provlslons ollaws and ordinances goveming thls type o/work will be completed <br /> whethcr specified herein or noG The granfing of a permd does notpresume to give authority to <br /> vlolafQ or cancel fhe provisions ol any other sfate or local law regulsting conshuction or fhe <br /> perfomiance o/construction. Thaf 1 am authorized by fhe owner ol this property fo perfomi the <br /> work for whlch applicatlon Is made and I comply with Uie Sfafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� �� 0 � ` /� <br /> Signature Dale <br />