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, <br /> �, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <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 <br /> n.0 lJUD 1��w��i /�v; <br /> PROJECT ADDRESS <br /> '�VERG �T' r�NrSL�� l=i1[i��rE� ��ST�Cic' tVE,QE tT 1�j9 �a.201 <br /> OWOet A7ail Addmss Ci�y Slale2ip Phone <br /> GevhAl 5����,euµ �000 Nrw„r r ���crr �,/� 18.�a� y�s�3aa�aGoo <br /> Tenant Mail Address City Slale2lp Phone <br /> �c�AN� r�Ecr�e�� <br /> Electrical Conlraclor Atail Address City Slate2ip Phone <br /> r�✓t��c.svF I ol Ku `� � 1 vv0 <br /> Stale Lir.ense Number Contracl Prico oi Work <br /> L uc nr r crR - <br /> Proposed Use of Building Conlact Person (Plan Roview) <br /> DescriplionofWorkloDeDune: I�� r��+�:N F.CJuir°n�LN � � L�iSHwti�itf� MAkC �U/' /tIR qN�r <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F�E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITf OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(}�fhaf 1 hare read end examined this application and know the same to bo true end <br /> correcL All provisions o/laws and oMinances goveming fhis type ol work will be completed <br /> whefher specified herein or noL The granfing o!a pemuf does nof presume fo�ive authonry fo <br /> violafe or cencel fhe provisioru ol any ofher sfafe or local law regulating consfruction or the <br /> perfomiance o/constniction. That I am authonzed by fhe owner o/fhis property to perfomi fhe <br /> work lor which application is made and 1 compty wifh the Stafe Confracfors Law 18.27 RCW and <br /> 296.2��WA . �/ <br /> l/ � � IU ��� �b8 �j �) <br /> Signature Date <br />