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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 G _a �.� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���06`���'t' <br /> �201 �Ra�D A�E <br /> PROJECT ADDRESS <br /> J�E +�q��5 iao� Car�an,n A,� F��'� 98�o I �l�s•`�`tz•5t5g <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenanl Mail Address Cily Stale/Zip Fhone <br /> P�►R Cmrvsuu�r,s G9io"R�n�vF,r-�uliwnr� O/ir� a.t,►2, SR.•t�rE. �uA- 9AA'� �•B?8•�B5 <br /> Eleclrical Conlreclor Mail Addross Cily Stale/Zip Phone <br /> Y(.i/nl_.1�..��7�Q� ��� <br /> Slate License Number Contracl Price of Work <br /> R�tv��irrM— Sr��E �Ar►t�u/ '�+ct"�°µ►tcElt' <br /> Proposed Use o(Building �— Conlacl Person (Plan Review) <br /> Description o(Work lo �e Donc: �G�GV C'I���12 �Jl�l YIl1I RF—��� z�U� � <br /> or c�ar�,F.,�r� r��, .� <br /> , <br /> � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, ti1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and exnrnined fhis application and know fhe same fo be We and <br /> correcL All pravisions of la�vs nnd ordinances�overnmg fhis typa o7�.ork�vill bo complefed <br /> uhefher specified herein or not The granfin�o/a pernut does nc f �iesume to give authonty to <br /> violate or cancel the provisions o/any other slate or local la�v reguL�ling cons6uction or fhe <br /> peAormance of constniction. That I arn aufhorized by fha u�rner o(thi.;p�opeAy fo peilorm the <br /> work!or which application is nmdo and 1 comply�vifh the Stafe Contrsctors Law 18.27 RCW and �� <br /> 296.200 WAC. /_ � ' <br /> � � o� <br /> , � �.��ri <br /> c iat ru Date <br />