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U� -aB-D,(� <br /> ' c; - �ta�03 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881� - FAX 425-257-8857- www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I <br /> ,, � ; ,l, <br /> ��53f CdL�3'F Av� o � , <br /> PROJECTADDRESS <br /> Owner MaJ Address Gty State2ip Phone <br /> ?���rt Sai-r'�1 a5r31 Coca3y A1.� CVCX.�%1 tJA ��,�OI �4Z5� 30'-(-�ZZS <br /> T� nant MailAddress City Staterzip Pnona <br /> W�,�� c��� lSI221.'R/�'h0�k� AV� slil I��t1iZ)N �A 98� ��5� a-�s-�o� <br /> EleciriC2lContractor MailAddress City S�ate/Zip Phone <br /> �ioLvr�L�:C7y 9i'�+ � `d5 i. o0 <br /> Slale License Number Contract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplicn of Work to Be Done: l+(�/� � � i�-d�^11� I�CC� 1�«-�- � L✓ �0/( � /f-' / � <br /> NOTE: vlIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� <br /> CITY OF EYERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 bemby certily fhat!have read and examined this applicafion and know the seme to be We and <br /> torrect. All provisions olla�vs and ordinances govemir,g tlris typo ol wor'n will bo cumplefed <br /> whelher speciLed herein or noL The granfino ol a pe�mrt does nof presume fo give authonry;o <br /> violate or canccl tho provisions o/any of4arstafo or!ocallaw regulating consWcfron orfho <br /> perlormanco o/constmchon. That!am aufh,orized by fhe owner ol fhis property(o pedorm fhe <br /> work Por which application is mude and I comply�wfh tho Stafo Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �l(.� _ �� 4�S10(, <br /> ��9 � Data � , <br /> / Lh�^ _ � �. <br /> l ' <br />