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� - <br /> ELECTRICAL PE�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.r.+verettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 0 Altil 1'O 4 PM <br /> 89� CoRB/N 1�,PivE <br /> PROJECT ADDRESS <br /> ,(�AVAR.a� �T����E� �yra �o,P,q�N ��uE �v�iz�rr v�A��as� r.�.�� <br /> Ownor . Mail Address Cily Stalo2ip Phone <br /> Tenanl MallAddress City SWIe/Zip Phone <br /> �o�/�n� �/T �,P /�S �l�s•7�2•J//!7 (�•P��",C� �DRD A.P/�it//7Gh� !�l/ff 3i'�54�?og! <br /> Electrical Conlraclor Mait Address City StatelLip � Phone <br /> .t'Aa�...� .z-ys i crT <br /> Slale License Number Contract Price of Work <br /> .�f�/JjT/Dn/ �'d2 /LIASTE� Eo.P�n /GoTT.s�/`� �"/�T �R.QU/�/ <br /> Proposed Use ot Buildinc� Conlact Person (Plan Review) <br /> Oescription of Work to Be Done: ir��l� AQQ�Zfy�� -ff��/TIiS�� �E—��OD/J7 <br /> --T <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 <br /> I hereby certily fhaf 1 have read and examined fhis application end know the same to 6e true and <br /> correcf. All provisions o(laws and ordinances govermng this f}�pe o/work will be completed <br /> whefher speci6ed herein or noL The granfing ol a pennd does nof presume fo give autbonry fo <br /> violate or cancel the provisions ol any other sfate or local law regulating consWchon or the <br /> pedormance o/consfiucfion. Tbat I am aufhonzed by fhe owner o/fhis property fo per/orm the <br /> work lor which application is made and I compty with fhe Stafe Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � ��d� <br /> 5i,na ure Date ,�aGf1&- i[ � <br />