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t <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /D —�""�9 <br /> d25-257-8810 - FAX 425-257-8857 —www.everettwa.org ��9iD_� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �//,� �-3 �'"/ �"/. <br /> PROJECT ADDRESS <br /> �Y�:y c _J,�.4 �7,:;j��:�� ZlIS Z3'd S! �vP�G`ll GJ., Sp°�ZD� `/Z$ -59�- 69�Z2 <br /> Owner Mail Address Gry State2ip Phone <br /> �� � <br /> Tenanl Mail Address Cily State/Zip Phone <br /> N, � ; ,/ , <br /> F(C� r�� :�:. /27zn y{�' �� G�. �vlrC!/ /.✓� `J��'7—�;'' Cy7y)33s-SGS,S <br /> ElecUical Contraclor Mail Address City Stale/Zip Phone <br /> �/s�orr = sc;hc� � yoo .�a <br /> State License Number Contracl Price of Work <br /> S ��t T�ti <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: ��' ��+-.�P .S�r;/i C� l��hG�o�S {3�/�,�,,�•� /yj�/� ( �tis� <br /> a ��� / <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � 7S".Do <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby ccrtily fhat I have read and examined this applica(1 pn and know fhe sarne to be frue and <br /> correcL A/l provisrons ollaws and ordinances goveming fhis type ol work will be completed <br /> whe0�er speaficd herein or noL The granfing ol a permd does nof�resume to give authonty to <br /> violate or canc�l fhe provisions ol any other stafe orlocallaw regulating construcfion orfhe <br /> perlormance oI construction. That 1 am authonzed by the owner o/this property to perlomi the <br /> work lor which applicafion is mado and 1�cxnply wifh the Sfate Contracfors Law 18.27 RCW and <br /> 296.200 W.4C. <br /> �� <br /> /-��' _ ,al�;/ s- <br /> Signature Date <br /> � oq�G-o38 <br />