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i <br /> � <br /> ELECTRICAL PERMIT APPLICATION '� <br /> CITY OF EVERETT PERMIT SERVICES ,,,�3_ir <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �I'I/ `D I <br /> 425-257-8810 - FAX 425-257-8857-www•everettwa.org '3-tJ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��b't0 Ows Av�ve �re.A ,E�Err,`�v�. <br /> PROJECT ADDRESS <br /> V S �A*1coRP ��Pr�'+JrF+���r'�- �310 �oQ•�� ,S�.1D�, M„Rs�w, . �tr. S1.2S8 <br /> OWner MailAddress City Slate2ip Phone <br /> S-r�w�aY�T�E '!$2D Onv s A�.�+� �A Evc:�.-rr,"►rA. qg?A3 <br /> Tenant Meil Address City StatelZip Phone <br /> 1�. T1 oR wEs-r —171 Scrr�+�►��" SrWc�� SEa-rrl.�Wa.98u8 '1D1o1dL3-31o� <br /> ElectncalContractor MailAddress City StatelZip Phone <br /> �1FA�UN'I..981SZ. � 3 S � p,oa <br /> State License Number Contrect Price of Work <br /> �w�-r T�-rt� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Wark to ee Done: 1 NS"�A�t-AT\ON oF 1�1, O NE 1 N�F�LN A��1 1LW M�NA"TGI� <br /> C\�ANNE�- l.6Tt6R SE-r To R� D "ST�'vA(LT�� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3705 <br /> I here6y certily(hat 1 have read and oxamined this applicafion and know fhe same to be true and � � � � � — p� � <br /> correct. All provisions o/laws and ordinances goveming th�s fype o/work will be completed <br /> whether specilied herem or nof. The granfing o/a permit does not presume to give authorify fo <br /> violate or cancel fhe provisions ol any other state or local law regu(afing construction or the <br /> per/ormance ol construcfion. 7hat 1 am authonzed,by fhe owner o/this property to perlorm the <br /> work for which applicafion is made and 1 comply with fhe Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> .,�,o�� , �� -3 -�1 <br /> Signature Dale <br />