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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STREET, EVERETT, 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 ACCEPTED <br /> lv/a�l Z"�a�o P �� � <br /> PROJECT ADDRESS <br /> � ,✓n11�_ /�'� i lI S I D l04 Td0.616 E4VN. �l/G✓�"I l w�S �tF26� ��25'353 3Lys <br /> Owner MailAddress City SWte/Zip Phone <br /> Tenant ,{ � � Mail Address City State2ip Phone <br /> �i ?.�6.3�.�.•4 S3 5" <br /> ���.�-� Fi::��,-,� �52a �y Sfret�- t�o n/� �acof�� w� 9�vz� <br /> Electrical Contrector Mail Address City State2lp Phone <br /> �-I�la 5� �` 02f �TG �' �o /000. � <br /> State Licecse Wumber Contract Price of Work <br /> F-'L',�1� , Ql.ut� �-.in�S�i <br /> Propos�;d Use of Building Contact Person (P�an eview) <br /> Description of Work to Be Done: FQ�o�a-�-� �l�c� F'�na.( �rrav � �m� �owQ� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and examined this application and know fhe same to be true and <br /> correct. All provisions o/laws and ordinarces governmg this type o(work wil/be completed <br /> whether specihed herein or not. The granting ol a permit does not presume to give authority'o <br /> violate or cancel the provisions of any other state or/ocal law regulating construction or fhe <br /> peAormanc=ol r,onstruction. That I am aufhon�ed by the owner o!th�s propeRy fo peAorm the <br /> work(or which application is made and I comply with(he State Confractors Law i8.27 RCW and <br /> 296.200 WAC. � <br /> ���..� �.�;�p� y�o�os <br /> �Signature Date <br /> �c� Soy-�r� <br />