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� <br /> ELECTRI�AL PERMIT APPLlCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 12 a"~�,-, / <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org E�0 �Z-A ot�i <br /> APPLICATIONS ARE A�CEPTED FROM 8 AM TO 4 PM <br /> � ao � � �� ba �� �Ur �� <br /> PROJECT ADDRESS <br /> � <br /> po (� ew, tis �tih <br /> Owne� Mall Address City State2(p Phone <br /> Tenant Mail Address Ciry State2ip Y�P�hs e <br /> �� <br /> es trica�contractor �� � ��M SAaa�� P�B ox S+��"�' � � W ate2i�a y3 �saon�S� <br /> � l� a� �� �, �oy NP _ 3 / s'o �= <br /> Siate License Number Contracl Price of Work <br /> F�"Otn Se <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion of Work to Bo Done: �/`} e,� e �6tiS Q <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TU FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y ihat 1 havo read and examined Ihis application and know fhe same to 6e(rue and �1 ���—UZ� <br /> correct. A/l provisfons of laws and ordlnances goveming this type of work will be completed <br /> whether specified herein or not. The granting o(a permit does not presume to give authonty to <br /> violate or cancel flie provisions of any other sta(e or local law regulsting construction or fhe <br /> peAormance of construcfion. That 1 am authorized 6y tl�e ownero/this property to perform the <br /> work lor which applicafion!s made and 1 comply wifh the Stafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� �-.. � 1.��— I � ' 0� - 10 <br /> Signalure Date <br />