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� ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—��.^•+w.evereV00VpRrg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> lcx� �� (5 Dr. Sr= <br /> PROJECT ADDF',ESS <br /> :�d�s-�r c��,s�(��� ����p P.v.��r�� D�.11�s �fi� 7s3e ( <br /> Owner MailAddress City Slate/Zip Phone <br /> G�4s� �GY'l 2 � �!'. S F �ve.t� 1..� (�- � �20�' <br /> Tenant MailAddress City Slate2ip Phone <br /> '1I � / �7 (� /I �/ Gns6�-vz�r-�3 zs-- <br /> V� -2jSf� � �4JU0 NW �l SOUC\ MQ7�+l� VE�KJ �N� 18.C�3 <br /> ElectricalContra or MailAddress City State2ip Phone <br /> �-e1-SCo12� �( l�''�� <br /> State License Number Conlract Pnce of Work <br /> Q�.<< �3��� c7.�� <br /> Proposed Use ot Building Contact Person (Plan Review) <br /> Description of Work to Be Done: "'� `�-��� ��` �v ��9ks �-�+��� �4u5� S��� <br /> � I,JcC�.� S t' �� 5 l U (c SC' � b <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 J105 (���-,) ` <br /> I hereby certify that I have read and examined this applicafion and know the same to be true and `� !(.��—C �I <br /> conecL All provisions olla�vs and ordinances goveming this rype ol�tirork will be complefed <br /> �vhefher specihed herein or noL The granting ol a pennd does nof presume to give authonty to <br /> violafe or cancel fhe p�ov�sions ol any other state or local lew regu/atmg construc(ion or the <br /> peAormanco of consfruction. Tha(1 am authonzed by fhe owner ol fhis property to perfonn the <br /> work lor which application is made and I compty with the State Contrac(ors Law 78.27 RCW and <br /> 296.200 WAC. <br /> ���.e-l�/�. �( '2U-� � <br /> SignaWre Date � <br />