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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32C!l CEDAR STREET, EVERETT,WA 98201 S— ���d <br /> 425-257-8810 - FAX 425-257-8857-vwvw.everettwa.org ��QO S�D� <br /> APPLICATIONS ARE ACCEPTED fROM 8 AM TO 4 PM <br /> lUt9 Pacilic Aec <br /> PROJECTADDRESS <br /> I'ugct�iunJ Kidncy C�cnlar lllll�Pac ific Aec liccrclt IVA,98201 425?59.�79i <br /> OWI10f MailAtldress City Slale2ip Phone <br /> I'S1�C <br /> Tenant Mait AOtlress Ciy State2ip Phone <br /> I'rrfcrrcd IJoclric 92�G 232nd titrirl tiW Gdmonds 1h'A,9fiU20 206A9�.G691 <br /> EleCtnCalContradof MailAdOress Ciry State2ip Phone <br /> I'RI:I I'.1[I�>_'��I'L .''��� � �d�Q� <br /> State License Number CoMracl Pnce of Work <br /> <)flicr 8rad Adcock. AWA <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description of Work to Be Done: ' ' � �YYk <br /> � - l,^ � �.Ss��.4 <br /> ; � ' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. y�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �! <br /> 1 hereby certily fha(1 have read and examined tlris application and know the same fo be hue and L--� ��"' I �� <br /> correcL All provisions ol aws and ordinances govemmg fhis type ol work will be.canpleted <br /> whether specified herei nof. The granhng of a permd dces nofp resume fo grve autbonty fo <br /> violate or cancel thep isi�ns o/any other slate or local law regula6ng construchon or the <br /> peAormance o/consiru fion: Thaf 1 am authonzed by fhe owner ol this property to pedorm fhe <br /> worY.lor which appl � is mado and I comply with fbe Sfate Caitractors Law 1827 RCW and <br /> 296.200 WAC. 1 <br /> �l'_dj lU <br /> Sign Date <br />