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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—wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /b Zy /�'�P .f f <br /> PROJECT ADDRESS <br /> ��uqr,,,, f j��, . r ���r�Bh�9ti���(l�,24 r��= s�. EUerc'll b,/� n7rS2�� y2�- Z94-8970 <br /> Owner Mail Address City Stale/Zip Phone <br /> ,�'V/�. <br /> Tenant Mall Address City State/Zip Phone <br /> f�i [..0 GI�Y"�ri�l I2?ZJ 9��/�vt L': !!r'10l E�Rrcr� G✓'` 'l�1c�Zo�r 52S 3SS'1��`/3 <br /> Electrical Contraclor Mall Address City Slalerzlp Phone <br /> /YOtJ, O•� <br /> f/ZL_��F.3 �L• 7J,r� <br /> State Lfcense Number Contract Price of Work <br /> , � , � To�-• <br /> f'r.r,-,r„ �'S il[:•<,Cc' <br /> Proposed Use of Buildfng Contact Person (Plan Review) <br /> DescripUon of Work lo Be Done: �h�� d ��'�o� ��ir AB fo zoD,/�C+i,�%'S �aa f <br /> , f <br /> ov(rlo�.,��%'l. r� �l� ��rE't��'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 �I D� � _ ` � � <br /> f <br /> 1 hereby ceAi(y fhaf 1 have read and examined this applicotion and know the same fo be frue end <br /> correcf. All provfslons oflaws and ordinances govoming thls type oI work wfll be completed <br /> whethor specified herein or not. The granfing of a permit does not presume to glve authority to <br /> violafe or cancel fhe provis7ons ol any ofher state or local law regulsting construction or fhe <br /> performance o/construction. That 1 am aufhorized 6y the owner o/fhis property to peAorm the <br /> work tor which appl(cation is made and 1 comply wifh the Sfafe Contrectors Lew 18.27 RCW and <br /> 296.200 WAC. <br /> `r�i�/ ���Z Z//L� <br /> Signature Dale ' <br />