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1 � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES y_.�_�o <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 42�257-8857—www.everettwa.org C/QO y�)��( <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> le1 °► <br /> .�Xf�'ari fic A V�i <br /> PROJECT ADDRESS <br /> Pul;et 4iund Kidncy Ccnlcr <br /> Owner Mail Address Ciry State2ip phone <br /> 5amc <br /> Tenant Maii Address Ciy State2ip Phone <br /> I'rcl��rrcd Ili'ctric 92°u 232nd Stra't SW I[dntondti 4VA 9H020 20bAla.b1<ib <br /> ElectricalContrador MailAAtl2ss ciry scate2+p Pnone <br /> I'I:I[I'I[I'I�72SI'I <br /> State License Number Contrad Pnce of Work <br /> Adminictrati��r(1(liic <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Desaiption of Wodc to Be Done: �`�����"'�`�n�Ol i k�n•ia�li+r�anstrudinn Po�cer <br /> NOTE: VIARING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereGy certity that 7 have�ead and examined this application and know fhe same to be frue and � I Q(�4 'I,�f <br /> cnrrecf. All provisions ollaws and ordinances govemmg this type ol work will be completed � i <br /> whether specified herein or noL The granting ol a permd dces notp resume fo give authonty fo <br /> violate or cancel the provisions o/any other state or local law regulafing construction or fhe <br /> peAormance o/construction. That I am authonzed by the owner o/this propeRy ro peAorm fhe <br /> work lor which applicati is matle and/compty with fhe Stafe Confractors Law 78 27 RCW and <br /> 296.200 WAC <br /> �� <br /> d/2b��lti <br /> /Signat Date <br /> l <br />