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l - <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 /> 532-� �a�ne (��� <br /> PROJECT ADDRESS <br /> �L�iC�Ed (�Qo�KI�S 6�?3 d�el d.S�' Ol�n,�lia u��9bs13 36�-2�o-aCc2 <br /> Owner Maii Aadress Ciry Slate/Zip Phone <br /> r,o�o�c �uc pp��Jif,Rll. 332G @�r��Rvc Euar�f{ wA��2ol YZS-D�ggao <br /> Tenant Mail Addr=ss City Stalo2ip Phone <br /> r1�t PQat�a�� I�J�, 1�3� C�1,^san K�. tve�i� (uA�splo� '2S�-9b'oa <br /> Electrical ContraCtOr M11ail Address Ciry Slate/Zfp Phone <br /> Hf.e 01 �'�21�C '1,350 <br /> State License Number Contract Price o(Work <br /> g- �SfnZS1 Q�� � . C�T$ <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Description of Work to Be Dane: �-��+ ���G� F�Q� ���� �r� T,.� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOGAL SALES TAX CODE IS 3105 <br /> ( I herebvi ceRify that 1 have read and examined this application and Anow the same to be true and <br /> co�rect: Ail provisions ollaws and ortlinances governing this type ol work will be completed <br /> whether specified herein or not The granting of a permd does not presume to give authonty to <br /> violate or cancel fhe provisions of any ofher sfafe or/ocal law regu/ating construction or the <br /> pedormance o/construction. That/ m authonzed by the owner of th�s propeity fo peAorm ihe <br /> work for which a�lication i ad�d!comp/y wifh!he State Cwitracrors Law 18.27 RCW and /�� �0 <br /> 296.200 WAG � ,� <br /> / <br /> �,-.��--�/ i�l�����y <br /> `j, <br /> Signature Date <br /> �4b�� � � <br />