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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERh�IT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �� .rJ�j -�6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � O6 �� �� <br /> g � o2 corbin D�'. <br /> PROJECT ADDRESS <br /> 7u��u 61qcKfoh� g9o � col•bih Dr. Evc;,r�tt. WA� `�B�D�- yz5•�3`�8-��529 <br /> wner MailAddress City State/Zip Phone <br /> � /H <br /> Tenant MailAddress City Slale2ip Phone <br /> L�nc� i>>r E� �ctl'i c I3359 N�. IGt� St 6�Ilu�u��-, W�1. '18005 '�•z5-56� i77 � <br /> Eleclrical Con�raClor Mail Address City State/Zip Phone <br /> LR�� DErS `I `I � BC I�YCC. oO <br /> Slale Licenso Number onlracl Price of N'crk <br /> S �naie� Fc1Mi � u Kr� St_ ( I��m� �� <br /> Propos d Use of Building Contact P�rson (�I^n Review) <br /> Descriplion o(Work ta Be Done: I\ t'l� �� �V 2 00 �rr� p �� n e'I <br /> NOTE: WIRING IN NON-DWELLINGS IS REUUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 55. 0� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> !bereby certily fhat I Itavo iead and examined fhis epplication and know fhe same fo be tme and <br /> conecL All provisions o/laws and ordinances yoveming fhis fypo o(work will be completod <br /> whether spociGed hore�n or not Tho granfing o/a po/md does not presumo to givo authority(o <br /> violato or cancel fhe provisions o/any oU�er stato or local law regulafing consfrucfion or(he <br /> peAormanco of construchon. Thaf 1 am aufhorized 6y Ihe owner of this property to peAorm the <br /> work for which applicafion is m e and 1 comply with fhe Sfafe Confractors Law 18.27 RC W and <br /> 296.200 Wf1C. � <br /> II� G � � �' <br /> � Signa u e Oale <br /> � <br /> �/' t%f�G <br />