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� � — ---� <br /> E�.ECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR�[T, 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 /> C ►�505-165 <br /> 5 -a8-�5 <br /> Icnoa C . �tic�r;ne Ui eu.-> Dr� ��, <br /> PROJECT ADDRESS <br /> (�Of_L�'�-]o(- <br /> Owner t.tail Address Cily Slale2ip P�one <br /> ESpr�55 o S-t-a� <br /> Tenan� MadAdtlress Gry State�Zip Phone <br /> �er�,�n�lcznc� Ele�'M;c �ao-r agan� �� �� �anwoc�d qg��a <br /> Elecirical Coniraclor htad Address Ci:y Statel2�p Phone <br /> �a5.�5u-5 ro <br /> �c=.i� Go�,i9t9o8 _ � ��o. °v <br /> State License Number Con�ract Price of Work <br /> t= 5�O re 5 so �-a-u�c1 <br /> Proposetl Use o(Building Conla�t Person (Plan Rev�ew) <br /> Descnpuon of Work lo Be Done�. ' <br /> Rd�! � c�r��.�.� -FDr c�t� eov�c� � � onG--�f' - 30�-►'►�� <br /> NOTE WIRING IN NON�DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. r-� s(� <br /> J � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby certdy thaf I have�ead and examined thrs applicaUon and know(he same to be frue and �- c <br /> conecf All provisions oi la�vs and ordrnances govermng this type ol�a-oik w�ll be completed ` � s � /— �7� <br /> �vhelher Specilied herein or nof The granfing ol a pennrl does nof resume to 9ive aulhonty(o <br /> violate or cancellhe prov�sions ol any ofher stafe or local la�v reguPfing consfiucfion or fhe <br /> pe�formance o�conslrucfion. Thaf I arn aufhonzed by Ihe on�ner ol fh�s property fo pe�torm the <br /> work loi which applicalion rs madz and I compry wrth fhe State Con(racfor5 La�v 19.27 RCW and <br /> 296.200 WAC. <br /> � �v�c�. ��t��rn �1aslts <br /> SignaWte Daie - <br />