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c <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 �d r�� � �` <br /> L�II10 ��� <br /> PROJECT ADDRE S <br /> �{+Z'3' �51-B�Sl�' <br /> $11�Y\�il.�b1A3'u�—�2�\� �+-`�^(�d11� �r '��yi,�� w�� °1��� <br /> Owner Mail Address City SlalefZip Phone <br /> Tenanl Mail Address Ciry Slale2ip Phone <br /> �}zs-sz�-3333 <br /> �o �.0 � �3�b���lnau�\ ��C10—Zi d—i1L1�'1����.0 v�n °I�a-[5 <br /> Eleclncal Contractor Mail Address Ci1y StalelZip Phone <br /> �2ec'4 'Gl`z�kq�l� [SQ� �'(�.<`.l7 <br /> State License Number Contrect Price of Work <br /> �,M� ,'m`��� (Y y.� . 1 Y�'Q,� .�.. � yy U.:\/1�-a <br /> Prapos Use of Buildin�j � C Contact Person (Plan Review) <br /> Description of Work to Be Done: �(�'�(,�P �� 01,`�c�1�(`(��� <br /> _� <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 /> I hereby certily Ihal I have read and examined this applic�,(ion and know(he same to 6e true and }.� I� � � U"} � <br /> conect. All provisions ollaws and ordinances governing th�s type ol work will be complefed �„� <br /> whether speci6ed herein or noL The granting ol a parmd does nol presume fo give aufhonty to <br /> violafe or cancel fhe provisions ol any other state or local law regulating consfruct�on or the <br /> peAormance ol conslr ction. �ha 1 am,.?cthorized by the owner ol fh�s property to peAorm the <br /> work lor which ap/J� fion is.�a a d'compty with the S(ate Contracfors Law 18.27 RC W and <br /> 296.200 WA,C' <br /> i " <br /> � � <br /> Signalurc ate <br /> I <br />