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— � <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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> ��� 2 �' lU�h �TR��i <br /> PROJECT ADDRESS <br /> �fZ�yl S I 8 zz <br /> C HR�srC.n[s�✓�N�+�r7y NaMEs i�/c, 2030 ��r_KfR A✓E E���-�-r �✓�-, 9�zo� <br /> Uwner P�tail Address City State/Zip Phone <br /> Tenant M1iail Address City State/Zip Phone <br /> Elactrical ContraCtor Mail ACdress City State/Zip Phone <br /> -�H/� ISG.�N f �"IC4 <br /> State License Number Contract Price of Work <br /> f\G��n lv.I •C_��J ��V�S�GNS�✓i <br /> Proposed Use of Building Contact Person (Fian Review) <br /> Description of Warkto Be Done: �cM�ORAKY OWG'R �dLE 6N T�� LoRNER� <br /> oc IU�` 5'[ AFFi An�� {�v �� a <br /> NOTE: WIRING IN NON-DWELLIPJGS IS REQUIRED TO FE"t <br /> BE IN RACEWAYS, MC OR AC CABLF. <br />; CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that!have read and examined this application and know the same to be true and <br /> correcf. All provisions of laws and ordinances goveming this type o(work will 6e comp/eted <br /> �vhether specilied herein or noL The granting o1 a permd does not presume to give authonty to <br /> violafe or cance/the provisions oi any other state or loca;law ieguiating construcbon or fhe <br /> peAormance o/construchon. That I am authorized by(he owner of this property to perform the <br /> �vork!or which application is made and I comply with the State Contrac;ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �) 7 <br /> �����..��Sj, ��%yrr�:%z.^� 2�2S�D.S <br /> Signamre Oaie <br /> .�L��� - �-� 7 <br />