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N � <br /> . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITI( OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 5 _ ���-I D <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org ��//� <br /> APPLICATIONS ARE ACGEPTED FROM 8 AM TO 4 PM <br /> C/� �� o <br /> �DI o23��' Dr w 3�d���'� <br /> PRQJECT ADDRESS <br /> Seww..�- Corpor.�� �.o�" .� [/�j32 A/fi 9�� ST' Sr�.� �J.4 9�/l5 <br /> Owner Mail Address Ciry Slate2ip Phone <br /> � �.1'h�n,}76n ,�oAtcf� �`�lo/ 23`'� 0� W. (��.� C—vcr�; !.�/� 98203 <br /> Tenant r Mail Address City SlatelTp Phone <br /> EVG/'q� l2ot�'�4�v^� �`02� cS K�+y.Non Su�r� Wf�' `f$lOY '�1D�i-�3- ��y <br /> Eleclrica Contrector MailAddress C�ry SWte/Zip Phone <br /> EVF fZG�2�.�i5LfZ $�c�o <br /> Slale License Number Contract Price of Work <br /> Proposed Use of B�ilding Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: .�n5fi� onc �!� �.:,`,r,,.,u.,,,6�c �Sta�'F <br /> NOTE: W�RING IN NON-DWELLINGS IS REQUIRED�O FEE <br /> BE IN RACEWAYS, MC OP.AC CABLE. <br /> CITY OF EVERETY LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and examined fhis applicalion and know the same fo be true and f� n/,� _ v f ! (/ <br /> correct. All provisions ollaws and ordinances governing fhis fype o/work will be completed /J (.+� 7"Q <br /> whether specd�ed herein or noL Tha granting ol a permd does not presume to give aufhonty to <br /> violate or cancel(he p�ovisions ol any other stafe or local law regulating construclion or the <br /> peAormance o/construction. That 1 am euthorized by Ihe ownero/fhis property to peAorm fhe <br /> wo�k lor which application is made and I comply with(he Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,G��� s/, ,o <br /> —� Signature Date <br />