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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-vwvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> 5��� a�Jr�" Dr. I,.� I�l� A <br /> PROJECT ADDRESS <br /> SQaWa-✓�. l��por�L �� JL� y�sz �ve 9�� sT ✓�LrT/�L W� 9���5 <br /> Owner Mail Address City State/Zip Phone <br /> �GB��n��fjn �,.vtor+ufcliC- 51�1 23�� 13 Gl �a. A rvcrL `7� C✓� 98203 <br /> Tenant � Mail Address Cily State/Zip Phone <br /> �VUr�'-p�e r� �Y/�4erz.�i�v �`02� 5 Y,eay�on Scw�C Wi4 9SlOFT 2o(.-�G3- 1�`/`/ <br /> Elect�ical Conlrac�o� Mail Address City Slate/Zip Phone <br /> Evr_ 2C-,2�9�sUZ $�vo <br /> Slate License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> i /� <br /> Descriplion of Work to Be Done: 1/�.S�w` bnc 1 /� ;7����,++m+.�i�c 7-'S�-'� <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 hereby certi(y that I have read and examined this applicafion and know tha same to be true and l — � <br /> correcL All provisions o/laws and ordinances goveming fhis lype oI work wi116e completed �) /��� e� <br /> whelher specified herein or noL The granting o(a permrt does nof resume to give authodty to � � vv i <br /> violafe or cancel the provisions o/any other state or local law reguPting cons(rudion or the <br /> perlormance o(consfruction. That I am aulhorized by the owner o/this properfy to per/orm the <br /> work/or which applica(ion is made and 1 compty with the Sfate Contracrors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ����-�.� s/r� io <br /> � Signalur=_ Dale <br />