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("� <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.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />_%�G'O �lard2s��n �oa� <br />PROJECT ADDRESS <br />ia -�a -08 <br />E� 8 r z. —o q.(, <br />SLS Nc�cle,�n L�� �b �c b� I ShoYe �; �e INA `��il S�o <br />OWflef Mai�ACdress City Slale/Zip Phane <br />Goc�c; c� 6?00 liar �e:An ��I Fotre�i l,�n _ 9�2�3 <br />Tenant Mailnadress Cily SlatelZip phone <br />Electrical <br />GFMNE�"M�t53d"� <br />State License Number <br />�1Jar Q��e ���� i P <br />Proposed Use of Building <br />Mail Address <br />'nnbre �/A qf�02� �/xs•y(�•34 <br />Cily Slate/Zip Phone <br />� bo0.00 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />DescnplionofWorktoBeDone� �I�S�QI� �Y7/ �In�C(���6�j�(iS <br />NOTE: WIRING IN NON-DWELIINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heroby certity thaf I have read and ezaminQd fhis application and know tho same lo be true ,�nd <br />correct. All provisions o/laws and crdinancos govenrng fhis lype o/ work will he complefed <br />whafher speci6ed hsrein or noL The �ranfing ol a pemiif does not Presume lo give aulhonty to <br />violate or cancel lhe provisions o/ any ofher stafo or local law regula(ing consfruction or fhe <br />pedormanco ol cnnsWcfion. That I am authonzed by fho owner ol Ihis property fo perfomi fhe <br />work /or which applicafion is mado ond I comply wifh Ihe Stafe Con6acrors Law 18.27 RCW and <br />296.200 WAC. <br />L✓! <br />FEE <br />�(kilZ-U�j�O <br />