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- — _ 4 -i/ - ��� <br /> E�ECTRICAL PERMIT APPLICATION <br /> CITY OF EVE62ETT PERMIT SERVlCES <br /> 3?.00 CEDAR STREET, EVERETT. WA 98201 �\n <br /> 425-257-8610 - FAX 425-257-8857 -www.everettwa.org �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> IC7� ( S E (;ve re l� 1���� 9��'a°�( <br /> PROJECTADDRESS <br /> ��o t�� <br /> �, ���er ' r su� /35/� .9l � ST sF .Sah��M%s/ (LlA 9�dq� Yob - �ai 3 <br /> Owner� A1ailAddress City Slate/Zip Phone <br /> Tenant Mail Address Ciry State/Zip Phone <br /> �..?�b'l <br /> �1��ltSC'��J/'/a���;� 7Y�0 �� ���tl Y'7ouA��,� �lii�c ` l� �'l�93 ?3S-87d,� <br /> Electrical Contractor Pdail Address Ciry SlatelZip Phonc <br /> /�QRASE i 9��� E �vs �� , <br /> Stale License Number Conl—r c Price of Work <br /> CPS[��GrS1ic, � !f'.SI`�C/1C�S �i�_ ��/nS�n (�0(� ��S^���� <br /> Proposed Use ot Building Contacl Person (Plan Review) <br /> Descriplion o(Work lo Be Done: � �, ,. � � �p , r <br /> �/�:�i4C,S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAEiLE. <br /> � .�� <br /> i� <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> �I <br /> , 1 hereby certily that I have read and examined this applicatiai and kno�v the same to be true and <br /> � conect All provisions o/laws and ordinances governmg this type o(work will be completed � <br /> whether specdied herein or nuL The c�ranting o/a pennd does not vesume to give authonty to � <br /> violate or cancel fhe provisions ol any ofher state or local law regulatinc�construclion or the � <br /> performance ol construction. That I arn authorized by Ihe owner o!this property to pedomi!he <br /> �aork lor which applicafion is made and 1 comply wi(h the Slate Cortractors La�v 18.27 RCW and �� <br /> i 296.200 WAC. <br /> v io c� � <br /> / Sic�naWre Date <br /> �C(c C•�- �i� <br />