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� � <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—wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I��U��Z <br /> C�.� �..vo�' <br /> 1 �b � �1)fY.2` �1Vf., �ve�.�k�t .�.1A, G�:�c� <br /> PROJECT ADDRESS <br /> 5�1��b�� Q]SP�n 1�6�� ooi.Y�n ��ve Fven�ft �hry �13�1 u,�5-a5�-�.�5� <br /> OWne� MailAddress City State2ip Phone <br /> Tenant Maii Address Clty SlatelZip P�one <br /> �'��G Z�c, i,� �1tle $�''� �4'r S'I S 52'I�FIL I,J�C1�l4y �E-7sS�331y <br /> Elec:rical Coniraclof Mail Address City Slete/Zip Phone <br /> sm�;zn5 �o�e� <br /> Slate License Number Coniract Price ot Work <br /> �',��c�;>��.� _ �rec r����� �,l 11 lu�,s <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work to Be Done: J I'�C 1,�1�1 lx� + 1�1����1���- �I[.)7 1�Gu� l���J�']� <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 /> I hereby cc�dy thal I M1ave read and examined fhis application and know the same to be true and G I 2 D� ' �� <br /> covecl. All provis�ons ollaws and ordinances govemmg fhis type o/work will be complefed <br /> whe(her specdied herein or noL The gran(ing o/a pemv(does notp resume to give aufhonty fo <br /> violate or cancel the provisions o(any olher sfa(e or local law regulating construction or the <br /> performance ol construction. That I am aufhonzed by the owner of this propehy to pedorm Ihe <br /> work�or which applica(ien is made and I comply wifA fhe Stafe Contracrors Law 78.27 RCW and <br /> 2PE.Z00 WAC. <br /> .. <br /> � SignaWre Date <br /> Z ��— �. <br />