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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 <br /> _. .� I> �'1 f\.� �� `< r � r� �i G�� <br /> PROJECT ADDRESS <br /> 9B a o3 <br /> li :,.,;," �� �fo�>r Cor����tK���'rc�' ,5��6 Ede�yrce �] w�� .:Sui�lt /00 �Ve�e¢-} h/A <br /> Owner `�—� Mail Address Cily State2ip Phone <br /> ►�a5- 353 -7oy3 <br /> Tenanl Mail Address City Slate/Zip Phone <br /> ►- i .r�1 �c_o �is3 � Ro�seve�.-f �����y N.�'. Sf��file �v4 98► �5 (ao� sa.��e S <br /> ElectriCal Conlraclor Mail Address City Slate/Zip Phone <br /> l t n <br /> i I � i{ , I {` � 0 I ►'J Z. �, �-I �i'� <br /> Stale License Number Contra Price o(Work <br /> � � <br /> 1 � .il .. '�. r, `r�i :�tL <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description o(Work to Be Done: ���� �'� .�i F� '�� � �-� � � � ��"� p <br /> NOTE: WIRING IN NO�'-DWELLINGS IS REQUIREC TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily fhat I have read ond ext�mined fhis applicafion and know fhe same to be true and <br /> conecL All p�ovisions o/laws and o�dinances governmg this type o(work will be completed <br /> whefher spec��ed herein or not The granting ol a permd does not presume to give aufhonty to <br /> violafe or cancel the provisions ol any ofher state or local la�v regulatinc�conshuction or fhe <br /> perlormance olconstruction. Thaf 1 am aufhonzed by the ownerol fhis property to peAomi the <br /> work Ior u�hich application is made and 1 canp/y with the Stafe Confractors La�v 78.27 RCW and <br /> 296.200 WAC. <br /> ' ,, " ,� ._�;--�-�.�. � - � 4 D� <br /> . <br /> Signature Date <br /> Fo�o3-� 3� <br />