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( <br /> ELECTRICAL PERMIT AP�LICATION <br /> CITY OF EVERETT PERMIT SERVICES I <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 <br /> ��Zr� ��U� a3r� �r. W �1U3 <br /> PROJECTADDRESS ���,�e{E yy/! (�p�p-j <br /> �C�VGiIc!'C' Vcl��-✓ TF� � . .��7�—C <br /> Owner Mail Address City State2ip Phone <br /> ��Lj✓�< <br /> Tenant Mail Address City Slate2ip Phone <br /> g5�5 8���,��,,.k7 �'3uc;> v���s,ii� <br /> I���S ('�,,nM�.,;�,-I,•:� S�(J�L•�, T�� ���- � � wn 9�a� <br /> Electrical Contractor Mail Address City Slale/Zip Phona <br /> ��S11vC5 9c�1lfS� �IUI , �' <br /> State License Number Contract Price of Work <br /> Uc�cc�n��n �'-�c��.�a� S�, �S l�Pi'�L1 '�s� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Oescription of Work to Be Done: ���� 57ti �I � �Y UOi�e�%7„u-C ('ji,�le-I�S. <br /> NOTF: 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 �. 1 /�G�!� <br /> I hereby certi(y fhat 1 have read and examined this application and know the same fo be frue and l�`L v� '•- v"'�^ <br /> correct. All provislons o(/aws and ordinances governing this type o/work will be completed <br /> wl�etherspecified herein ornot. The granting o(a permit does not�resume to glve aufhonty to <br /> vlolale or cancel U�e provisions of any ofher stato or local Ir w regulafing cons(ruction or fhe <br /> pedormance of construction. That 1 am authonzed by the o.vner of Ihis�roperfy ro pedorm the <br /> u�ork Ior which applicaHon is made and 1 comply with the State Contractors Law 18.27 RC4t�and <br /> 296.200 WAC. <br /> /l� ��`�"�ly�/l� <br /> Signalure Date <br />