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r � <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 ACCEPTEO FROM 8 AM TO 4 PM <br /> y 7i7 G�W1 S'r <br /> PROJECT ADDRESS <br /> �T/�CI�- � �A2oL `ARP� Cv�T WA �5�-UB <br /> Owner hlail Address City State2ip phone <br /> Ten�nl A7ail Address Cily State/Zip phonc <br /> �M �(�iIV7-Y /=�(,ii4(C. LO IN �. <br /> [leclrical Conlraclor btaii qddress city s�;do2ip Phone <br /> _J�( C �:l hJC'C..00 �' jJ J <br /> Slale License Number Contracl Price o(Work <br /> /'XS� ST� N (� 5 +=�'' <br /> Proposed Use of�uildinp Conlact Person (Plan Revlew) <br /> Description ol Work to Oe Dono: .1= �L IjC� 1jX S I$1 ih1 p� p 7�Ap S�2V�.�- W �T 4� IJEW <br /> �u1rLL `/s' 63.Tl1 ATT/jCf�1,J7 (�AR F_ - NEW � (,N11 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cwii/y fhaf I haee read and exernined this application and kno�v fhe snme to be f�ue�nd <br /> correcL All p�ovisions ollaivs and adin<vicos gaveming this fype ol�rork will be cortipleted r (�[%Cl —�)�'� � <br /> whefher spea6ed heruin or not The�ronting of n perrnd does notp reswne to gi��e aufhority fo <br /> violafe o�cancel the provisions ol any other state or local la�r rec�ulating consfruclion or fhe <br /> perlomiance o/consf�uc(ion. Thaf 1 arn aufhorized by the o�t�ner oI fh�s property to peAonn tho <br /> work lor which applicafion is mnde ond 1 compty�rifh the Sfate Confractors Lmv 18.27 RCW and <br /> 296.20014�AC. <br /> �( ��� � — �(� —( � <br /> �ignaWre ,�% � �—.� Date <br />