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( � <br /> ELECTRICi4L PERMIT APPLIGATION <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 -DEBIT 8 CREOIT CARDS ARE NOT ACCEPTED <br /> �I��� ��I��n�i.0 ,��, <br /> PROJECT ADDRES <br /> ��� P�� /`�11�1.C�'V� I�1N���-1��? �,�tr�1� <br /> Owner Mail Address City State2ip phpy <br /> Tenant Matl Address Cfty State/Zip pApne <br /> � ���� �h��u � �o�M� v�r� � ��(� G�� <br /> EleCtrica�Contraclor Mail Address Ciry StatelZip ph� <br /> �L�C�C 10�'�D� �I ��(�1"')`" <br /> State License Number Conhact Price ot Work <br /> ��YG <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Description of Work to Be Done: �Ql��Q l� ���1�) t7-� �,ly,./� (���(,� ���it�� _ <br /> d <br /> GI'�C���IIn;UI ��� �/� � �Ol�� C� r�11��, I �� �.C� ('G4f'1�� ,t r�l l.l I Ts <br /> � � i �4°�� ���r,� �? «r�ll c,� . 1,� C� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily thaf I have read and examined fhis ap�lication and know fhe same to be true and <br /> correct. All provisions oIlaws and ordinances govemmg this type ol work will be completed <br /> whether specified herein �r noL Th.r granting o/a permd does not presume fo give authonty fo <br /> violate or cancel fhe provisions o/any ofher s(afe or local law regulating construction or fhe <br /> peAormance o/cor�fruction. Thaf I am authorized by the owner ol this property to peAorm fhe <br /> work/or which a /it tion is made and I co ly wifh the State Confractors Law 18.27 RC W and <br /> 296.200 WAC. / <br /> f � <br /> � 5 �.� �S� I <br /> Sign:,Nre i D te � � � <br /> f - / <br /> ( <br />