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_- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 15i I wQT►�oR� d�E�u E <br /> PROJECT ADDRESS <br /> 66oFF E�►�5 IS�1 WE71�o�E Av6n►UE 6�1�E1r/1�1A (�61T18-o4Z8 <br /> Ownef Mail AdCress City tate2lp Phone <br /> �— <br /> Tenant Mail Address Ciry Stale/Zip Phone <br /> EP�c E�Ecn�� ^ �ac-. Pa BoK 357 SNa+bn�sN�wA `�'8�► (360 �ts-sles <br /> Electrical Contractor Mail AdEress City Slate2ip Phona <br /> E p2 c�T yF � 33�F <br /> State License Number Contract Pnce of Work <br /> St/�►G[.� FA+�I�-Y f�s'cOrrrstl-` <br /> Proposed Use of Building Contact Person (Plan Review) <br /> , <br /> Description of Work to Be Done: �Q7 !+�'�P O�'^ " —" — SE��CE �-M+"�E� 3 <br /> � - I.S!(�E CX�5`n!�6 Ql�J�+�1cN CC1eG tJ lTs . Q PQI20�C �$b <br /> SQ i'[' ��J���fDwF�.�r�G SPAc� - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRify that I have read and examined this application and know the same to be true and <br /> wrrect. All provisions o//aws and ordinances govermng this rype o/work will be completed <br /> whether speci6ed herein or not 7he granting ol a permrt does not presume to give autbonty to <br /> vlolate or cance/the provisions o(any other state or loca/law regu/ating constnrotion or the <br /> performance o/construchon. That I am authorized by the owner o/this property to peAorm the <br /> work lor whi lication is made compty with the State Contractors Law 18.27 RCW and <br /> 296.200 W C. <br /> 03 ° zoas , /J�611 <br /> ignawre �a g � / <br /> ��Ll� <br /> � <br />