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r <br /> t <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � ��q �� � <br /> 3200 CEDAR STREET, EVERETf, WA 96201 <br /> 425-257-8810 - FAX 425-257-8857—www.everetlwa.org ��10 S—�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �la� �/oK.�� � <br /> PROJECT ADDRESS <br /> � <br /> Owner Mail Address Ciry State/Zip Phone <br /> P�hZ.MA (.�i �r�wrze,�.�� 3'� g N��cnN,�� ��c�,-� `f�s zsd- 36 <br /> Tenant Mail Address City State/Zlp Phone <br /> �Dc� Er,�-�2�c, Yl► � /S��ST-✓v„�/ �/wu�� w�r 9da9 Z- - <br /> Electrical Contraclor Mall Address Ciry ` SlateRlp Phone <br /> �DGE�z936L3 2��3/i`3 � Zo�o <br /> State License Number ��ap Contract Prico of Wark <br /> �7�l 57NG- P'—�I�/�A C,<-1 M C. <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplfon of Work to Bo Done: 1.���n E� �� M�T� �V� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this application and knor�fhe same to 6e fnie end <br /> correct. All provisions ollaws and ordfnances goveming this type of wc 1c will be completed <br /> whether specified herein or nof. The granting o(a permit does notpresume fo glve authority to <br /> violete or cancel thep islons of any ofher sfafe orlocal law regu/afingp onsfructlon or fhe ��I,� <br /> perfonnance of const c on. That 1 am authonzed by the owner of this roperty fo perform fhe ��i <br /> �vork lor hich appf fi is made and 1 comply wifh fhe State Contractors Law 18.27 RCW and �/� <br /> 296.200 AC. � I' J <br /> i <br /> .^ <br /> ' Signat Date <br />