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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREEI, 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 /> - ; 1�������12 �` ��57� ��✓ ' Z� �'����� <br /> PROJECT ADDRESS <br /> �,; ,,�,�,��� �� , �� �a9y� ��� U. <br /> Owner Mail Address City Stale2ip (�-�a/ Phone <br /> /QGC��P <br /> Tenant Mail Address Cily Slate/Zip Phone <br /> �'����'�''� �A�/Sf� �K/ - <br /> Elec�ncalConitacbt fdailAddross Cily Slale/Zip Phone <br /> �j..���v � �" / �/ �7(/�'_ <br /> tato License Number Contract Prico of Work <br /> -� C%i 7,�1� �,% 7�i 1 <br /> Proposed Usa o(Building Conlact Person (Plan Review) <br /> Descriplion of Work lo De Done: �''���/ ��� �� � nCC�C/ ���Cdf j <br /> — ' ��l . -�/h��� �crn d�iTe arl �� ��a��,�S <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby ceriify U�at 1!�m-e read nnd e>:amined this applica(ion and kno�r fhe same to bo f�ue and <br /> eorrecL All provisions ol laws and or'dinances goveming fhis type ol�rork a�ilf bo cornplefed � <br /> whelher spea�ed hacin a nuL Th�granting ol a pernut does aof �resume fo give authonfy fo �, <br /> viola(e or cancel tho prov�sions ol any otlier sfafe or/xal law regulnfing consVucfion or fhe � � <br /> peNonnance o/consin�ction. Tha(i arn authorized by the o�vner o/flus property fo perlonn the �� <br /> �irork lor irhich application is rnade and 1 comply wifh Ihe State Centractors i arv 78.27 RCW and `� 1'l� <br /> 29G.200 6VAC. <br /> � �� ti� �� �Z �`� !�� <br /> . -sipnaWro Da <br />