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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9d201 <br /> 425-257-881�J - FAX 425-257-8857—www.everetivra.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I �'t� � 1 N � �v�P'C' �I v z <br /> PROJECI'ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> �l u � �S�� C. Cq�� (,sye�i�� <br /> Tenant Mail Address City State/Zip Phone <br /> � / 1 _5pv� <br /> ;1 `�_ Zvo 5 � U%Cq5 S�' s�'n�N_ �VHl9'�?0l �i1�3347� <br /> Eleclrical Coniraclor Mail Address City Sta e/Zip Pha�e <br /> �1u�Ul�' �� � 16 �.� <br /> Stale License Number Conlract Prico of Work <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Descriplion of Work to BQ Done: I �I S�G I I�1��L' �� �� I G �V �� fJ I I S� l.) 4� �' _ _ <br /> `= ;i 5��� Ltil <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 CODE IS 3105 <br /> I hereGy certify that 1 have read and examined this application and know fhe same to be hue and <br /> conect All provisions ollaws and ordinances goveming this type o/work will be complefed <br /> �vhether specified herein or not 7he grenting of a pemut does not presun;e to give oathonty to <br /> violafe or cancel fhe provisions ol any other state or local law regulating construction or fhe <br /> per/ormance ol coristruction. Thaf 1 am autfiorized by fha owner of fhis property to peAo�n the <br /> work for which application is made and 1 comply with fhe Sfate Confractors Law /8.27 RCW end <br /> 296.200 WAC. <br /> � ' � �. <br /> � �i /i� . /�'%� � �Vi��06 <br /> � SigdaWre �,t- ale <br /> j�� � / <br /> ECtn 11 -�7 Q �r- I <br />