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i <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE�'1� PERMIT SERVICES � _a3 �� <br /> 3200 CEDAR STRtET, EVERETT, WA 98201 ��y <br /> 425-257 8810 - FAX 425-257-E857—www.everettwa.org L.�/� p (�� <br /> APPLICA110NS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �,� Gr <br /> PROJECT ADDR S <br /> �e�Obi c. f'1/eW�1 e� 109�i�q�l�/h.c �wc� -'l.�h qflld � Z'�S'8���'1 <br /> OWner Mall Addr Clty State/Zip Phone <br /> Tenant Mail Address City State/Lp Phone <br /> ����x 4«hn� Iayzl ����-.1� C��J'��c� � SnfP C�r.tr��-av <br /> EleCtriCal Conlractor Mail Address City State2ip Phone <br /> l�/�OVES � 52QCh �� � ' � <br /> Slate License Number Contract Price of Work <br /> de���d �r�5e � - <br /> Proposed Use of Buil n Contact Person (Plan Rev(ew) <br /> Descriptio ofWorktoB Done: �111�II � �� .f��lel • I� II_ / �L(",O��N• _ <br /> ��I d� !�� <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 /> 1 hereby certify Ihat I ha��e read and examined this application and know the same to be hue and �I �� / K Z <br /> correct. All provislons of laws and ordinances goveming thls type o(work will be completed <br /> whether specified Oerein ornoL The grenting o(a permd does not presume to give authonty to <br /> violate orcancel the p�ovisions olany othersfafe orlocallaw regu/ating construc(ion orthe <br /> performance o(construction. Thaf 1 am authorized 6y the owner of thls property to peAorm the <br /> work(or which appllcation!s made and Iv with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 6 Z`� r � <br /> Signature DatT <br />