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� <br /> FLECTRICAL P�RMI� APPLiCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, Et�:�"��=!T, WA 98201 y�I 8"« <br /> � 425-257-8810 - FAX 425-2�':� " :;r —www.everettwa.org GJ w I( Q(/ ��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '�j'L2� t.ofr��� /k-�IE L`"VC�72..�.1 `?�� ( <br /> PROJECT ADDRESS <br /> R���,����N�'z— i�� t�+3��E�� ���,�v�u� w� �B�7z_ ��-3s�-7�zc� <br /> Owner Mail Address City Stale2ip ��_G�Phone <br /> Tenant �� ' Mail Address City Stale/Zip °hone <br /> EleCtrical COn�lor �11 Mail Address Gly Slale/Zfp Phone <br /> ��5 ooe <br /> State License Number Contract Price of Work <br /> ti,�G� ���Y �,D�� �,� c�l��— C�-�,� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriplion of Work to Be Done: 5 NEU-� C�l.(N �"l�d-�� �"w��� �'��t �A»� �'�'�' � <br /> ��, �x �o �a� afr� An�J�a�. r(� C��uNC-, o.r� �� ���+�-S <br />�� <br /> g�2�onM- , a�� asc,��R��'� �- wa�c.� cuZ�sS f P�o� r5 <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 C�� � O�-I — OOIj <br /> 1 hereby certi(y that 1 have read and exarnined fhis applicatipn and know the same to 6e(rue and <br /> correct. All provisions of laws and ordinances goveming th!s type of work will be complefed <br /> whether specified herein or not. The granfing o(a permit does not presume fo gfve authonty to <br /> vlolate or cancel the provisions of any other sfate or local law regulating consfrucfion or fhe <br /> perfomiance of constructlon. That 1 am authorized by the owner of this�roperty to perfomi the <br /> work(or which applicafion is made and I comply with the State Contrec(ors Law i8.27 RCW and <br /> 296.200 WAC. <br /> !� r ��X 1 �� <br /> Signature � ��a <br />