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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.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`.� �� .i . � Y' Y <br />z-3e�i-�-Z-3z�� R�,�n�c� �I�c,, <br />PROJECTADDRESS <br />I� q� C i� I-IeM e <br />Owner <br />C�,�m ec�c�� IC 1 � <br />Tenant <br />�,f� �ti <br />Electrical Contrador <br />State License Number <br />Use <br />rt 2��� �ai�e� l�vc <br />IAail Addreu City <br />b�cj �3�`� �a; ��e� <br />Mail Address <br />City <br />uc rc'� \�,i �1$ "LO <br />State2ip <br />C fCfl WA ��' Z� � <br />(-Zc i•� <br />�yl �111�1 <br />Phorre <br />State2ip Phone <br />Mail Address City State/Zip ��IA�e <br />/ \ <br />�C i�' ��ol� ��f l�3 / i 7 <br />Contrad Price of V1'ork <br />Contad Person (Plan <br />Descriplion of Work to Be Done: 1•1J U t- C��l�� �'� c� f���y4- '�1 �L� r� l S� � U\ L. `, <br />i"�5 r� e a 1 � <br />ac� �r <br />s� , <br />NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS J105 <br />I hereby certdv that 1 huve read and examined fhis applicafion and know Ihe <br />conect. All provisions o/laws and ordinances goveming this type ol work w <br />whether specified herein or not. The granting ol a pomrrt does rrof prasume <br />violate or cancel lfie pmvisions oI any ofher state or focal law ragulating con <br />pndormance ol consin�ction. Thaf ! am au(honzed by fhe owner o/ this prop <br />�vork /or which application is made and 1 compty with fhe State Confractors L <br />296.200 WAC. <br />_ � . , r <br />_, _ <br />s l0 6e true and <br />completed <br />re authonty fo <br />tion or fhe <br />o peAorm the <br />�827 RC W and <br />FEE <br />