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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 /> c� I(� GEc,e..�- ,J,z� . <<��rr 9 e z o3 <br /> PROJECT ADDRESS <br /> �/�=�=�J� S�.-�oo�- OTSTrLTG7 � iYIAOlSO�/ �! £.vl. <br /> Owner Mail Address City Slatc2ip Phone <br /> Tenanl Mail Address City SlatelZip Phone <br /> �1ns,.t:�'k4..4z ����— T.o b�X �8�n �Lw.or�r,�. wa ��, 43o1y vzf �7s•(cs- C <br /> Elecirical Contractor A7ail Address Cily Slate/Zip Phone <br /> w <br /> �r?ar,�,SEro>iOK Yoo <br /> Slate License Number Conlract Price of Work <br /> `/�iJuL �-/AvG� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description o(Work to Be Done: �-°�`' V��',« �4 �-� n:�w G'C.��c,¢o r�� <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 ,!��, ' C.0� �� <br /> I he�eby ceriily thaf 1 h�ve read aod examined fhis applicafiun and know fbe sarne to be frue and � <br /> correcL All provisions olla�vs and ordinances c�ovemmg flus type ol work�vill be complefed <br /> �vhether specified herein or noL The granfin�ol<i pennd does nct presurne to give authonty(o <br /> violate or cancel the provisions oI any other state or local la�v re�ulatin�constnic6on o�Ihe <br /> pe�formance ol canstruction. Thaf f am authorized by the o�vner o/ihis p�operty to pedorm fhe <br /> work lor�vhich application is made and I comply with fhe Slafe Confracfors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> , /i%� � <br /> 0 <br /> �� . _--�; _ � �� -s-� o� <br /> ��� SignaWre -_ .._ Date <br />