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( <br /> ELECTRICAL PERMIT APPLICA��ION <br /> C"TY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVER�TT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM J— G�� `' <br /> / <br /> C/ ZOl -�a..Jr <br /> ��I2� �n\J�nn4ia � '� i- �K-�e��l � <br /> PROJECT ADDRESS <br /> � r:� ae�.�. C�,��p 2-� vr W �12� �13 113b <br /> Owner Mall Address Clty Slate2ip Phone <br /> Tenant Mail Address Ci!y State2lp Phone <br /> �� �,, �-�,3►� ( � Sl- S 1�;�(��e� .,�t ��alzl��-�-lo 0 <br /> Electrical Contractor Mall Address City Stale2ip Pl�one <br /> g�eR-o�Pa�o ,mti _ I }wv <br /> Slate License Number Contrect Price of Work <br /> �25\�v��(ti 1 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> .� <br /> Description of Work lo Be Dono: N Cu� l2 S�R �- ���•� �^ � � <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 2 U� �d ZS <br /> !hereby certi(y that I liave read and examined this applicafion and know the same to be true and C� <br /> correct. All provisions of laws and ordinances goveming thls type oI work will be completed <br /> whether specified herein or nof. The granfing oI a permif does not presume fo give authority to <br /> violate or cancel fhe Provisions ot any other state or local law regulating constructlon or the <br /> performance of construcfion. 7hat I am aufhorized by Uie owner of fhis property to perform the <br /> work(or which application fs made and 1 comply with tho Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> � <br /> ature D te <br />