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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> i t�o l `a � �� 5-�- _ Gv�a.:�f- <br /> PR JECT ADDRESS <br /> �� M08� <br /> 1601 �t�S� • �� a��-�38 ( <br /> Owner Mail Address Ciry StatelLip Phone <br /> ��,r l� i <br /> Tenant Mail Address Ciry SlateiZip Phone <br /> / Q <br /> ��-� ���-,� al N,� ���� � G n� � � A 9� �7-�r� <br /> ElecMcal ntractor Mait Address City Stale2ip Phone <br /> �..��c�-TF'+'��l'�S l�/"C ��b �-°a <br /> State License Number C tnoiact Price of Work <br /> t�we�l�r�a� <br /> Proposed Use of uT ng Conlact Porsun (Plan Review) <br /> Description of Work to Be Done: O�Q7� ��-�C`t�p� L�9�Q�d� _ i Vf� .++lw �i���o,n l�.lS� <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 3106 <br /> I I hereby certifv fhaf I have read and examined(his application and know the same to 6e frue and <br /> correct. All pn�visions ollaws and ordinances goveming this type ol work will be completed <br /> �whether specil:ed herein or noL The granfing ol a permd does not presume to give authority fo <br /> violate or cana:l the provisions of any ofher sfafe or local law regulafing consfrucfion or the <br /> erlormance o.'construclion. Thaf 1 am authorized by the owner o/(his property fo pedorm the <br /> work Ior which e pplication is made and 1 comply wifh fhe State Contrac(ors law 18.27 RCW and <br /> 96.200 WAC. <br /> � � � � g� <br /> _�.=" \ - -� � 15 r � <br /> Slpri tule %�- �" Da e �l� n <br /> / U u, <br /> � <br /> � <br />