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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org )0- 5`C6 <br /> � 0�71 �.7. �'o� <br /> P.PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �oo� asf� sf <br /> PROJECT ADDRESS <br /> �CG��. .�f�n���a �9ano /92// &9�a A.t .✓c /�'/�;,5.�-,., wA `1�23 ,�1a-49S•�o61' <br /> Owner L9ail Address City Stale/Zip Phone <br /> �� <br /> Tenanl Mail Address City Slale/Zip Phone <br /> l�/n c r' <br /> Elecirical CoNraclor Mail Address Cily Slate/Zip Phone <br /> Slate License Number Conlract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Worklo �e Done: S� 'f �C Kaaro� /"oo.e�^ �o% <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�S 3105 <br /> I hereby certily Ihaf I have read and examined this application t�nd know the same to be frue and <br /> conecL All provisions ollaws and ordinances govenung this fype of work wil!be completed <br /> whether spec�fied herein or noL The�rantin�oI a pennit does not resume to give aulhordy to <br /> violate or cancel the provisiau oI any ofher stata or lucal law reguPfing construction or the <br /> pe�forrnance o(construction. Thaf 1 arn aufhonzed by fhe owner o/Ihis property to per(orm th,e <br /> �vod<lor�rhich applicafion is made and 1 comply�vith the State Confrac(ors Law 18.27 RCW and <br /> 296.200 INAC. � <br /> i <br /> fr ✓ <br /> ��c/1n,�.. XJ �� /0'S-0 Co / r1 � <br /> Sign�x ure' Data � r � J <br /> �� <br /> I <br />