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l <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES J�-a9-i� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �/��� `Iq/� <br /> 425-257-8810 - FAX 425-257-8857—www.everetlwa.org 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,� � , � /9 CJ� ,�P � <br /> PROJECT ADDRESS <br /> /'� �✓r/'Pff� i'ah� �/,G — <br /> Owner Mail Address City StatelZip Phone <br /> Sjf��t�✓f �,�/C' r} � .�,� s �'/..6 <br /> Tenant Mall Address Cily SlatelZip Phone <br /> �/1 J- <br /> P���s.a / �/<<F�- .T r'o�{ � v4 /��l K .S !ri( S�'ds 3 3,�0 1 P�,. <br /> � ' Phone <br /> Electrical Conlractor Mall Address City State/Zip . <br /> 300 -s;5,, .,�� <br /> f'i�� r r�-:l� 7 ��i( ��s� "� l <br /> Stale Lfcense Number ContractP ice of Work <br /> r� �� �P <br /> Proposed Use of Building Contact Person (Plan Revfew) <br /> Descriplion of Work to Be Done: �l�/�i�� .S ��� Ci�C � ��/oU� h �O o�`- <br /> r <br /> — � fi ih <br /> /ct', t S� nc p /�o ,�.cr <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 �'� � � _ � 9 y <br /> I here6y certi/y if�at I havo read and examined this application and know the same to be true and <br /> correct. All prowsions ollaws and o�Ninances goveming this fype olwork wi116e completed <br /> whether speci(ed herein or not. The granting of a permit does notp resume fo give authorify to <br /> v(olafe or cancel the Provisions o/any ofher stata or local law regulaGng consfruction or the <br /> performance o/construcfion. That I am aufhorized 6y the owner o/this property to peNorm fhe <br /> work/or which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �!� , ' l� f��� / /� � s /�� <br /> Signature � Dat <br />