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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 -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> 221`5 ��Urn (3) � <br /> PROJECT ADDRESS <br /> ItAA��� ��°s . <br /> Owner Mail Address City State2lp Phone <br /> Tenant Mail Address City S�ate2lp Phone <br /> Su m r� �T C�cc,-rR�c. I tiL 6 2.a 3 ?.C�I ST N:J nl �x,q l.v.� i e 2`f 2 <br /> Electrical Conlractor Mail Address _ iry Slate2ip Phone <br /> r,, y25 3oa 5� <br /> 4�MM IC I �0 KZ ��71C� �4, y� <br /> State License Number I Conlract Price of Work <br /> 1 <br /> S r• R-� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: W�FE 1�1 CW 5 �' I`• �� AM P SE�V�� <br /> NOTE: W�RING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> 1 hereby certify fhaf I have read and examined this application and know the same to be true and <br /> correcf. All provisions ol laws and ordinances governmg this type o/work will be completed <br /> whether specified herein nr noL The granting ol a pemtd does nof p2sume to give authonty to <br /> violate or cancel fhe provisions ol any ofher stete or local law regulating construchon or the <br /> peAormance o/co�,cation�s�ade and I co�m�I Z w th the Stafe Cont a�cforsPLaw 18.2 RCW and <br /> work lor which ap, PY <br /> 296.200 WAC. <br /> �.,�— g� Z6� a y � Cb <br /> SignaWre Date /� <br /> F���g-��� �G� <br />