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( <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 /> '1�01 -�V.¢.re�� (av,an�- <br /> PROJECT ADDRESS <br /> G�IMarc. PPAI �Ia1� S�oS�t.�nz���w ll.2�� -f�«H �� -gsZ�� Yts-Jrt b�j <br /> Ownef Mail Address Cily State2ip Phone <br /> Tenant Mail Address Ciry Stale/Zip Phone <br /> -fir�2 ni�?�ti�i�n�Ir,c . 1�30 ,�Ixon Q.I . �.,<ar2�f� �✓�-9�2oy Y7C Z9C_q60o <br /> Elecirical ContraClor Mail Address City State2ip Phone <br /> �Rr pl� ��I r�L- ��-���0 p� <br /> Slate License Number Conlract Price of Work <br /> g /� i2o� L . c ATS <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be �one: <br /> � i�.l VO��t7��{'I�'f A��n"1 <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 here6y certily that I have read and examined this application and know the same to 6e true and <br /> correcL All provisions ollaws and ordinances goveming this type o)work will be comp/eted <br /> whether speci�ed herein or noL The granting ol a permd does not presume to give authonty to <br /> violate or cancel the provisions o(any other state or/ocal law regulafing construchon or the <br /> performance ol construct n. That I am authorized by the owner or this property to pedorm fhe <br /> work for�vhich applieaN n made and�y with the State Contractors Law 18.27RCW and <br /> 296200 LVAC. j <br /> l� ' <br /> cL• c3 vS' <br /> awrei Date _ � � <br /> / t' �Ln <br /> j� . J <br /> ✓ <br />