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( <br /> ELECTRICAL PERMIT APPLI�ATION <br /> CITY OF EVERETT PERMIT SERVICES ��19--07 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org Co�o�--o c(3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��� �'�e�ZjZ l� Cr.� ��-Ic�� <br /> PROJECT ADDRESS <br /> �S��.J C,l,� G L�' 11�'F' �,L�, �#300 I�°��P�l u D �(�Olr-� - <br /> Ownef �dail Address City Stale/Zip Phone <br /> l��o►nc�' ?_�C� I�('✓� «��rIL P � C p.�}- �20 . <br /> Tenant M�il Address Cily StalefZip Phone <br /> ��-e.�d Q.�-e l �ne 5c�� � s-r n� ��ar����� c��s <br /> EleclriCal Contractor �1ail Address City State2ip Phone <br /> �Ji1/�QA�4 L�iCt �I��— ��f oU,(.2� <br /> Stale License Number Contracl Price of Work <br /> ��if/� <br /> Pioposed Use of Bailding Conlacl Person (Plan Review) <br /> Description of Work lo Be Done: <br /> ' y� � <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to Ge frue and <br /> correct. All provisions ollaws and ordinances goveming th�s type o/work will be completed <br /> �vhefher speci(ed herein or noL The granting ol a permd does nol resume fo give authonty fo <br /> violate or cancel Ihe provisions ol any olher sfafe or loca/law reguPfing consfn�ction or fhe <br /> pedonnance o/construction. That 1 am aulhonzed by the owner o/this property to pedorm the <br /> work/o, hich application is made snd 1 comply with the Statc Contracfors Law 18.27 RCW and <br /> zse. oo nc. ^ �/1 - �_� <br /> J <br /> � -� � a _ � � , <br /> Si�notu�e / <br /> o,�o -J <br />