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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �2�� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org (� ' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �D�O6��� <br />( � — <br /> Lti�� �� �G s� I r��rA �o� ��-,w� . <br /> PROJECT ADDRESS <br /> � M� ri r�,� sN,vcr� �Nv�s�m��r�3 �0 3ax 1059 .Snohom�5h �WA QS2`�� <br /> Owner Mail Address City Stale2ip Phone <br /> ����,,�-� II'-i1� I`l�` A-vF SE Um� �ol �v�.�-t_r (��A <br /> Tenant MailAddress City State2i0 Phone <br /> w�s-r�n1 l�� Z��b Isr av� S . S:� w� �'8i3y 2o�-�gz-��3s� . <br /> Electrical Contractor Mail Address City � Slale2ip Phone <br /> C(/GS�iv._zo � �o� 2�0 � � <br /> Slate License Number Contracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work io Be Done: �/�ST�/'�i f-� ������� W�� �� /1�'S �{7�/[� <br /> 0�/� �:� 7t/�//l��i� <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 certily fhat 1 have read and examined this application and know the same to be tnie and <br /> correcf. All provisions o/laws and ordrnances goveming fhis type ol work will be completed <br /> whether specified herein or not. The granting ol a pemut does not presume to give authonty to <br /> violafe or cancel the pmv�sions of any other sfate or local law regulating cronstn�chon or the <br /> perlomiance o/construchon. Thaf I am authorized by fhe owner oI this property to peAomi the <br /> work Ior which application is made and 1 comply with fhe State Contractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> � - y 25 Zoa�. <br /> ' ignaWre a1e <br /> � ��";�� <br /> . <br /> ,,�=' ' <br />