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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EYERE'IT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf,WA 96201 <br /> 425-257-8810 - FAX 425-257-6857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT JICCEPTED <br /> _j �,� �o f�f�)�-I 1' �� ��/�✓�77 "/ ��I <br /> PROJECT ADDRESS <br /> �r�r✓�f ,-Kar�n ���mal�ll ICb��: l�vf fv��.��/� i,rJ� 9�,�1 <br /> Ow;1er Mai Address City State/Zip Pha� <br /> � /� yas -asa- �vo5 <br /> Tenant Mail AOdress City Slate2ip �:one <br /> ��d �13-� ,pr <br /> Elednpl ContraCtor Mail Address Ciry State/Zip Phone <br /> Sfate License Number Contracl Pria�of Work <br /> YIC�;, /�� ��l��'„�'� <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Descdption of Work to Be Done: �F��)I'I r f � a��� � c7O0' Cl'/r�/J �5 P�'vIC' �' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEW.4YS, MC OR AC CABLE. <br /> _`� <br /> �J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify fhaf I have read and examined fhis applicafion and know the same fo be true and <br /> c:..^^^_� All provisions o/laws and ordinances govemir�fhis type olwork will be�mpleted <br /> whelherspeafied herein orooG The granting ol a permrt does not presume fo give authonty fo <br /> violato or cancel the provisians of any ofher sfale o�local law regulating consfrucfion ot Ihe <br /> peAormance o/consfruclion. Thaf I am a�thonzed by the ownero/this pmperty to peAorm the <br /> work Ior which app/ication is made and I comply with the State Conlractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ' �� - //� <br /> '� � � �r� � ia la �� � � <br /> Signatu Dato � <br /> E�412.-If�{' <br />