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—t . <br /> ELECTRICAL PERMIT APPLICATION <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 <br /> G � <br /> �—�-���1 MO N I'�=� <br /> PROJECT ADDRESS <br /> Owner Mail Address Cily Slate/Zip Phone <br /> Tenant Mail Address � City Stale/Zip Phone <br /> '-125 30� 57 S� <br /> �mC�1\T CI.Cc`I��c. 6203 2�ISt-ST ,,,�� S�71n1i,,cuG WA c1621� <br /> Eleclrical CoMtaclor Mail Address City State/Zip Phone <br /> ��rn(v� l C i a��v j«. 5v�u <br /> Slate License Number � Contract Price of Work <br /> S� �2- <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Description of Work lo Be Dona: ��"-� Z-`� ��M� 5 C ��'��C �..! 1 I"C /��IfJ j_�I` • i <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 /> 1 hereby certily that 1 have read and examined Ihis applicafion and know Ihe same to be frue and �U�D 1-V�'��j <br /> conect. All provisions ollaws and ordinances�ovemmg fhis type ol work will be complefed <br /> whefher speciGed herein or noL The granfing oI a pennd does nof presurne fo give aufhonty fo <br /> violafe or caacel the provisions ol any olher sfafe or/ocal law regulafing construction or fhe <br /> performance ol consfruclion. That 1 am airthonzed by the owner of this property to per(omi tlie <br /> wo�k/or�vhich applicalion is made and 1 comply with the Slafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ���—____ � � ��, � i , 2a� � <br /> Si�naWre Date <br />