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/ � __ <br /> ELECTRICAL PERMIT APPLIC�T:�N <br /> CITY OF EVERETT PERMIT SERVICES y_os.-i� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � ��Q�_��l� <br /> �25-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,�4i� FiNN s�. <br /> PROJECT A�DRESS <br /> G i E,. o � �'v�.z� <br /> Owner Mail Address Clty SlatelLip Phone <br /> rvt:kc ►Qe�,1„se.� :�1� C.c�.. .Sr�. ,�K.�.6� W.���l�Lai S�.r!'.ts'7 8&9S� <br /> Te�ant . Mail Address Clty State/Ztp Phone <br /> �.e�� �'� � i <br /> Electrical ConUaclor Mail Address City S1ate/Zlp Phone <br /> t0 <br /> �3 ao0 —' <br /> State License Number Contract Price of Work <br /> _ .Q.C� �v CtltlSS f�di .it•.J YL�r.�elL CiaK. ///•�+c ��cfe.� X� �i. <br /> Proposed llse of Building Contact Person (Plan Revlew) � <br /> � <br /> Description of Wark to Be Done: �wS�«f/ Qcv� �ca,/.✓ co..e..l� Or�.- S�n� <br /> / // <br /> .?d o� �� r_/c��.,•e�/ l�.r�i.'�. <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 3105 F <br /> I hereby certi/y thaf I have read and examined this appfication and know the same to be frue and v ` �U�—O 1 y <br /> correct. All provlslons of laws and ordinances goveming th(s typo of worlc will be completad <br /> whether specl�ed herein or nof. The granfing of a permif does not presume fo give authority to <br /> violate or cancel the prov(s7ons of any other state or loca(law regulafing consfruction or the <br /> perfomiance o/consirucfion. That 1 am a�thorized by fhe owner ol thls property to perform the <br /> work lor which application is made and 1 comply wlth the Sfate Contrectors Lew 18.27 RCW and <br /> 296.200 WAC. <br /> e������ J� .�/ <br /> rSignature Date <br />