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� <br /> �LECTRICAL PERMIT APPLICATIO�! <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everethnra.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> l(1"�01 RnF.KP�P l I er flvE. <br /> PROJECT ADDRESS <br /> R'C�� SzNt�t�Sky la�a RocKe�e.l�r Wve E�����_ Fff��� 9$�O / <br /> Owner Maii Address City SWte21p Phone <br /> Tenant Mail Address City State2ip Phone <br /> �e a2 Wirzfaz��e, oZ�l-1 13oT" ar ,e� Lakc S+e�e.,� w,� `�rSotS�" y,�s-335-1yo7 <br /> Eleclrical Conlractor Mail Address Cily Slate2ip Phone <br /> yc��a-w;�,�aKc �� s�.o� <br /> Slale License Number Conlracl Price of Work <br /> S,F /Z <br /> Proposed Uso of Building Contact Person (Plan Review) <br /> DescriptionofWorktoBeDone: �aJ~ I�IrlD SC�✓if� 1>P4P�d�+ OVe(I'�t'HL1 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 fiereby ceifily thaf!have read and examined this applicafion and know fhe same fo be frue and <br /> correr.t All provisions of��ws and ordinances govemi,ig this fype ol work will be r.ompleted <br /> whelher specified heroin or not. The granting o/a pemiit does not presume fo give authonty to <br /> violate or cancel fhe provisions ol any other stafe or local law rec�ulating construction or the <br /> performance o/construction. Thaf 1 am authonzed 6y lhe owner o�this property to pedorm fhe <br /> work lor which application is made and I comply wifh fhe Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �-� G'. ���� y i9- os <br /> � Signalure Date <br /> �asoy-o�g <br />