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� <br />o� , <br />ELECTRICAL PERMIT APPLIC�TION <br />CITY OF EVERETT PERMIT SEf�',VICES <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 <br />31ZO I✓l�DouL�ACL �V� <br />PROJECT ADDRESS <br />Owner <br />Mail Atldress <br />Ciiy <br />�i -a b -Iz <br />� �'-�`���K(� <br />Slale/Zip Phone <br />i�NIt�D WR+� 3120 MGDOU(afill �Q'l�� ��EeET� �a���� phone <br />Tenant hlail Address Cily State/Lp <br />Tr�anf Fc.ec,-r��c� qDU rJ ��l'��r� l08 ��a,zE W/���8io� 2a�,��i•23i! <br />Eletirical Contraclor Mail Address City StalelLp Phone <br />�raNF!%GZ,O� <br />State L;cense Number <br />Proposed Use oF Building <br />3 e�v . <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: INh'�AII �l /1�rv1.V OJZ E1'� LI %%� ��� DFF t.Yl�i�(� <br />DAv� t�o4� in�hl�)I! di' ���1G�1�"� � rlFw .:�-t��a"n�iFy <br />� x � ti �';�� ��� <<n ;�l? <br />NOTE: WIRING IN NON•DWELLINGS IS REDUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABIE. I r�S O <br />l� <br />CITY OF EVERETT LCCAL SALES TA% CODE IS J106 <br />1 he�eby certi/y that I havo read and ezamined lhis application and know the same to be frue and � 1 <br />correcl. All provisions ollaws and o^�inances govQmmg Ihis type ol work will be complefed ZU �' ��i <br />whether specitiod heroin or noL 7he granfing of a pemut does not presume fo give aufhonty fo <br />violafo or cancel the provisions o/any olher sfafe or local law regulating consfruc;ion or fhe <br />perlormance of construcfion. Tbat 1 am authorized by the o�vner o! fhis property to perfomi fhe <br />work lor which application is made and I comply wifh Ihe Sfate Coniraclors Law 18.27 RCW and <br />296.200 WAC. <br />