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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVE�cTT PERPd!f SERVICES <br /> 3200 CEDAR S�REET, EVERE"fT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-•www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT.^,CCEPTED <br /> /330/701'�l�ver��c , �v�cff� I,✓�'� 98.�0/ <br /> PROJECT ADDRESS <br /> � 5 „ � C��%s��� /330/�!/✓r,��rc, �✓��cff W� 9�,tU/ va5-�79a� <br /> OWner � MailAddress City Slato/Zip Phone <br /> !1/of o�i a/,/G _ <br /> Tenant Ma�l Address Ciry 5tatelZip Phono <br /> �f✓� �������Gi. <br /> Electnca Onifactor Mail Address City Slato/Zip Phona <br /> /1/�i a�v/rlA�/c_ � <br /> State Li nse Number C tract Price of Work <br /> /l'/./.',2'i /'(PS/.�C/1�G <br /> P'roposed l�se of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: //��Cl CYiSf//.�Q CNCC�fS � CJnI�i f f0 /7('W 2���' •`-����'G <br /> /r�i fo �im,f No. EOSJ7-U70 ) <br /> � <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 COCE IS 3105 <br /> I hereby certify thaf I have read and ezamined this applicafion and know(he same to be true and <br /> correcf. All provisions o/laws and ordinances govemmg fhis type ol work will be completed <br /> whether spec�(ed herein or noL The granfing o/a permd does not presume to give authonty fo <br /> violaha or cancel fhe provisior,s o(any o:t�er state or lor.al law regulaling construction or(he <br /> pedormance of consWction. Thaf 1 am aufhonzed by fhe owner ol(his property to perlorm fhe <br /> work for which application is made and I compty wifh Ltie State Conf2ctors Law 78.27 RCW and <br /> 296.200 AC. <br /> �-- '. U% 2U� 1,�7,rj. <br /> Signa e ale <br /> � Vc ��.� / � / <br />