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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 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> II '?_ �`L � �� rc11 tilllll ��''(� S►— <br /> PROJECT ADDRESS �— <br /> I k i�rnr�-t �t c ��r � ��:.Nt<<�r� �1- 1► � � A � � hi i , � � ,,.�;�� �u,�c�� � <br /> Owner Mall Address Ciry State2lp Phone <br /> �(:` e � � � �t� kc�r.�c� 112L�, ; tic11- 1.11� I 1�1nt,t Cr . L4 �� r(-ti ��'fl <br /> Tenanl Mail Address Ciry SlaleZp Phone <br /> �n�lk ��f nr� I��E c�l I�u , '�>�<<���. .>;�al� A�.� ��-�it; , LciL' � ���r�( t„q �����9 z��3-� �A''- <br /> EledriC31 Contf3ctor Meil Address Clty State/Zlp Phone —�T��O <br /> AM�.��N� nr,2 �.�� "f�-► ac� --- <br /> Stete License Number Contract Price of Work <br /> ��e -4t��,1 E��Sa . S� r�h�i <br /> Proposed Use of Building Contacl Person (Plan Rev�ew) <br /> DescriptionafWorktoBeDone: ��IIIRI�P �X.IS11 ��L����� (,U �}�� {'lPl,tl ��e, <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIREO TO FEE <br /> BE IN RACEWAYS, MC OR AC CAB�E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceAi/y tliat I have read and examined this application and know the same fo be l�ue and <br /> conect. All pmvisions of laws and ordinances goveming fhis fypa of work will 6e completed <br /> whefharspacified herein ornot The granfing o!e permrt does no1 presume to give authonfy fo <br /> violafe or rancel fhe pmvisions olany ofher sfefe orlocallaw regulaling construction or fhe <br /> porformance ol constructlon. Thof 1 am authonzed by Ihe ownerolthis property fo peAorm Ihe <br /> wak lor which appfication is made and I comply wifh the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � , � �L . 9 �t° <br /> Slgn ure D le <br />