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, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM f � �3 �O 6 <br /> 12 3 . E ��i�� r�_EI YY�C111 �1.1(lA_.� <br /> PROJECTADDRESS <br /> Owner Mail Address Ciry Statc2ip Fhone <br /> n� 2�t� ��aL <br /> ��. �� `11nf�111 eC 4��5 E. 1'1'lnrrinfi.l � St(i.4-FlL lA)Q �v�10� lS�n E' <br /> Tenant Mail Address City State2ip Phone <br /> czs31 y 3�- <br /> In4 cc� Ll. ' Ialv2S loZnci �a�c S �C-IC�I �'e�.i—� �,UC� �Qi03Z qf5°� <br /> Electrical Contractof Mail Address �,City State2ip Phone <br /> �'' <br /> 1 NTGc�L � �14�0��1 � I- ',_ y 2��U �C� v <br /> State License Number Contrect Price of Work <br /> �i�5ECl1� nP�,l \lr,�cr� .5- c'1C14fa Cfs �jA� <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Descriplion of Workto Be Done: ��'(1�1, �`�) '�s `nS�'Ct�� Y\P1.1� C� Q��_ '(=��{�f�l!�vi_ <br /> UC)',C P 4- C10.-�('v ('(l ��1 C?�, <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERET7 LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that 1 have read and?A�amined this application and kno�;fhe same to be true and <br /> correct. All provisions of laws and ordinances govemmg fhis type uf�:ork vill te completed <br /> �vhether specified herein or noL The granting of a pemut does not presume to give authonty to <br /> violate or cancel the provisions of any other sfate or local la�v regulating construchon or the <br /> peAormance o/cons!ructior. That 1 am authonzed by fhe owr,er o/this property to perlorm the <br /> work/or�;hich applicafion is made and I comply with the Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��,��� f�n2�,/���1 , IU i3-ut� , i � �"1 � <br /> / Signature Datc ; , <br /> �' <br />