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r <br /> ELECTRICAL PERMIT APP�.ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wvr+v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 18 � 8 3y- T? ST <br /> PROJECT ADDRESS ��� � SF�, <br /> Ro 6 erT S�{� /e,'�'�er.s 111 a ° ��4T�� e Gva 9�/ ? 8 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State2ip Phone <br /> �CTt'G2�7 <br /> ElectricalConVactor MailAddress Clty State/Zfp Phone <br /> Slate License Number Contract Price of Work <br /> ►�,Q.�ir�¢G�.4.� /Qo�� a�o6' � 375 .. o3s3 <br /> Proposed Usa of Building Conlact Person (Plan Rev(ew) <br /> � <br /> Descriptian of Work to Be Done: �'�=1�/� � � ��� �� �"� � � <br /> ( C. /O — �O/�O <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 3705 <br /> I hereby ceriily that I have read and examined fhis application end know the same fo be frue end <br /> correcL All provisions ollaws and ordinances goveming fhls type o/woif.'will be completed <br /> �shefher specified herein ur noL The granting o/a permd does notp resume to give authonty to � <br /> violafe or cancel the provisions ol any other sta(e or local law reguleting consfruction or the <br /> perlormance o/construcfion. That 1 am authonzed by the owner o/this property to peAorm the _ � <br /> work lor which applicafion is mado and I comply with tho State Contrectors Law 18.27 RCW and �D� � �\� <br /> zss.zon wac. <br /> ��� ��c�� l � � l 9l/O <br /> Sig�ature Date <br />