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( ( � <br /> ELECTRICAL PERMIT �1Pl�LICATION <br /> CITY OF EVERETT PERMIT SERVICES i .../�_�Z <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �,�I�y 7 <br /> � 425-257-8810 - FAX 425-257-8857-www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> oL��� �G« �c. �vQ— <br /> PROJECT ADDRESS <br /> py,,�e� Mall Address Gty SUIe/Zip ���_ Phone <br /> ��f- W P��ern 1('� S��rf�a �n/► S�� ?_�- l�f I <br /> Tenant Ma�lAddress Gh SmtelLp �� Ph°"e <br /> �I Qr��-rc S2co • �Zpp�' St NE I��a#�n .W�-�t��a � .?.�8'-777�0 <br /> ElecMcal Contractor Mail Addresa CiH S�a�e/ZIP q'°"0 <br /> .n � �}'�M / <br /> // t� W <br /> Stete L cense Number� . � Contra Price of Work <br /> h� I�-� ° <br /> Proposed Use of Buflding Contact Person (Plan Review) <br /> Desaiption of Work to Bo Done: I / �� C �`^e `r� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO �E <br /> BE IN R,4CEWAYS,MC OR AC CABLE. ��UU' <br /> lJ <br /> CI'�Y OF EVERETT LOCAL SALES TAX CODE IS 3105 �� <br /> 1 here6y ceRily fhaf 1 have read and exemined thls applfcation and know the same to 6e We and E I Z� I _ Q <br /> comect. Alf provislons of laws and ordinences govemfng thls rype of work wl11 be complefed <br /> whether speclBed herein or not. The grantlnp of a pem�rt does not presume fo glve authority fo <br /> vlo/ete or cancel ihe provisions o�any other stete or local law reguleting constructlon�r the <br /> pertortnance of cons�ructlon. 7'hat I am authortzed by the owner o/thls properiv fo per�Orm fhe <br /> work lor which appl(cation!s made and 1 comply wRh the Stafe Contrec(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � ��� '� � <br /> Sig ature� . ate <br />