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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �j—a.I—�) <br /> 425-257-8810 - FAX 425-257-8857—www.everetriva.org C ( 10/ _� ,_, / <br /> — �o �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �OSOD C✓�26/tFf�t.�a y <br /> PROJECT ADDRESS <br /> ��/ db r/"'�1"�l'�5 � C' Phone <br /> Owner Mail Ad ress Ciry StatelZip <br /> MA�I C �lf 35/h✓ 0� F✓�(l��� Pho,� <br /> Tenant Mail Address C�ry State2ip <br /> �/• ;�d�L 5��� CaI� �2�¢ 2dz-ora� <br /> —I-. S e2ip Phone <br /> Electrical Contractor Mail Address ���Y � <br /> �a�osc�3i►+�3 Zso� <br /> State License Number Contract Price of Work <br /> ,F�1fo n��t��i�° S�c% T..h�►a���,�✓ <br /> Propose�Use of Building Contacl Person (Plan Review) <br /> �,✓jrM�t oNf �✓F�✓ w�9K ,y/u✓i C�,✓,✓F�1 7o CA"/31�✓6 <br /> Description ot Work to Be Done: � �� i� <br /> S16� h�zrN�T ��h^' 'in�6'it ��G�rf�s I1E/�Glt� I�tllf�.�wr�✓t�" . <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 he26y certify that 1 have read and examined this application and know the same to be true and C! I/`/__ � <br /> conect. All provisions of laws and ordinances goveming this type of work will be complefed < <�w� � <br /> whether speafied herein or,noL The granting of a permd does not resume to give aufbonty to <br /> violate or canc I the provisions oI any other state or local law reguPting construction or the <br /> performance co truction. That I am authorized by the owner o/this propeRy to peAorm the <br /> work lor whic ap atio is made and I comply with fhe S:ete Contractors Law 18.27 RCW and <br /> 296.200 V✓A . <br /> Jl�ll _ <br /> Si atu Dote <br />