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� , I, <br /> ELECTRICAL PERMIT APPLICATION �I <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EV�RETT, WA 98201 ! <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.crg <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED � <br /> Ily�a 1qp ��e 5� � R io I <br /> PROJECT ADDRESS <br /> mn.r,ne�r su��are�n�¢�c�rnan�- �o. 4x,c losq Srv,\,am��h c�F� 98z�i r <br /> Owner Mail Address City State/Zip Phone <br /> Sl�5�11 `�\11(n <br /> Tenant Mail Address City State/Zip Phone <br /> ��zs-��y-d�U I <br /> i.,mpir, f`Sec�n r�,� 211�0 (��xi Air_G) �LD7 m��n�c2 �(YC�CG (4)EF �I'�Oy3 <br /> Electrical Contraclor Mail Address Ciry State/Zip Phone <br /> C��ymPm���2SX� <br /> State License Number Contract Price of Work <br /> Qe�o.�� �1om� �a�i�e� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: SrS'Yc�.\\0�'C��V� Q � 1 �Pf'r(1(1S I YA� <br /> NOTE: WIRINC IN NOI�-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that!have read and examined fhis application and know the same to be true and � <br /> correct. All provisions of laws and ordinances goveming this lype of work will be corrpleted <br /> whether specilied herein er noL The grantin9 0l a peimrt does not presume to give authonfy to <br /> violate or cance!the provis�ons ol any other stafe or local law regulating consVuchon or the <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for�vhich application is made and I comply with the State Confrcctors Lasv 18.2i RCW and <br /> 296.200 WAC. <br /> �J ��(/� ��� 2 I d 4 <br /> ignature Oate �� <br /> �; � � � L ; <br />