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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTE� <br /> �,�_�,w1A-�IIEV.J 13LD . <br /> PROJECT ADDRESS <br /> .�a S�Q� I��� s 3030 ���,R��� a�a . �,r�,r 41k �92a3 <br /> Owner Mail Address City State2lp Phone <br /> Tenant Mail Address City State2lp Phone <br /> �e�+z t-RCE Elec. .Stoo� l.�m,s,�cr,, A✓�• Gve,¢�� w4 • Yzs-2�o-�s�i <br /> Eleclrical Conlractor Mait Address Ciy Sule2ip �.� _ �e 77� <br /> .7�Q L��Gi 51 DD �r'r - .�Cv.�nav.i.r/ r'�' <br /> Slate License Number Contract Price of Work <br /> �q✓c S<�c_//a� <br /> �7 } Ioo— 2oa'tTt3 <br /> Proposed Use of Building Conlact Person (Plan Review <br /> . �vreY - yzsas�y�9D <br /> Description of Work to Be Done: U�r�Ya tPc fc�� /d,ry.« ��r/ r,/�.Lqq� <br /> � �F� i�v t3�7�/.2oan1 � .�'EJE�Se Po�•.4�i7�/ erc� o[.✓T� <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 i <br /> 1 hereby certi/y fhat 1 have read and examined this applicafion and know the same to be tiue and <br /> correct. All provisions o/laws and ordinances goveming this type o/work wi116e completed <br /> whether speci�ed herein or not. The granting o/a pennit does not presume fo give authonty to <br /> violate or cancel the provisions ol any ofher stafe or local!aw regulating consfnicfion or the <br /> peAormance of construction. That 1 am authorized by the owner o/this property to peAorm fhe <br /> wak(or which appiication is made and 1 comply wifh fhe Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��� ��` l0 ' ZV' S <br /> Signalure Date <br /> .!-(l J� ���� <br />