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� �- <br /> ELECTRICAL PERMIT APPLICATION <br /> CI7Y OF EVERETT PERMIT SERVICES �_�g_� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org ���O 5—�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��J � f-1 Q�I,P_r t�oac,� _ <br /> PROJECT ADDRESS <br /> /7�i kC� � ��'�2U2 <br /> -Tho, ,1ton Rb'c�,2 �hcx-/mJ CJmcl !_y� �vc�r�-t G�IA Sos-B�Fi-776� <br /> Owner MallAddress Clty g8�� SfateJDp Phone <br /> Tenant Mail Addresa City State/7Jp Phone <br /> Lt�/ Y` <br /> Electrical Conlrecto� Mali Address City SlalelLip Phone <br /> State License Number Contract Price of Work <br /> � e ��n ��� p Contad Person (Plan Review) <br /> Proposed Use of Build(ng <br /> Descriptfon of Work to Be Done: �Q`l JR- Gc� t �r'e YQ I)'1 OCl P � <br /> NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerfi(y that 1 havo read and exemined thls applicetion and know the same to be true and <br /> correct. All provislons o(/aws and ordlnences goveming fhfs type ol work wlll be completed <br /> whether speci0ed/rerein or not. The granting ole permd does nofp resume to glve aufhority to <br /> v!olate or cancal fhe prov7sions olany other stafe or local law regulaGng conshuctlon or tha <br /> peAormance o/constructlon. That 1 am aufhorized by the owner ol th(s property to peAorm fhe <br /> work lor which applfcatfon Is made and 1 comply with fhe State Confracfors Law 18.27 RCW end �0�, a�0 <br /> 296.200 WAC. / <br /> �� 2�„ -7/ � ,���,t S// �/ /i0 <br /> Signalure Dete <br />