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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 /> 16Lo (����e Sf. �v��P�� q�2UJ <br /> PROJECT ADDRESS <br /> Owner A9ail Address Cily Slale2ip Phone <br /> .��I l + L P e ���iP�f A-��� � u .S 75z, llcX� <br /> Tenanl � ail AdCress City Slate/Zip Phone <br /> ��ck QaKKP� S'7Zy I`l7�'AveNC Col(e5�-Pv���s wA 492�'R y S' S9.(�/ <br /> ElecUical Coniractor A1ail Address Cily Stale/Zip Plwne <br /> �Zc I(RBQ9 6 7J K �"DO�, °° <br /> S ate License Number Contrect Price of Work <br /> �Ps�dP��e ��K �4 P,- <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> Description af WorP lo De Donc: �� W��'C' P�l ��6��� � /V�'w .�C���I�C P , <br /> - i � - o(o <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 3705 <br /> 1 hereby certily thaf 1 have read and examined this applicotion and know fhe same to be frue and <br /> canecL All provisions o/la�vs and ordinances govemin�fhis type oI work will be complefed <br /> whelher spealied herein or noL The granfing o/a pernuf does nof presume fo give aufhority fo <br /> violate or cancel lhe provisions o(any ofherstate or local law regulefing consfruction or fhe <br /> perforrnance oI constiuc(ion. That 1 arn aufhorized by fhe owner o(fh�s property to perlorm Ihe <br /> work!or which applicafion is made and 1 comply with fhe Stafe Confroctors Law 1 A.27 RC W and <br /> 296.200 WAC. <br /> �'� Z , B.c� <br /> ignaWre Date <br /> �\ . �l f' � <br /> Yv �(� lp� <br />