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r - � <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S -8—a� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �� go5„�� <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> �i�l7o C'�'� ,�e ����r� "� � �' � <br /> PROJECT ADDi2ESS <br /> %G�� 5,��1- l� ' ��1Z�� C��y ����_ ��� <br /> Ownel Mail Addres^ Ci�y Sfa'e/Zip Phone <br /> / . / �/� <br /> --�� ' ��('� ��� (/�'�0���� <br /> T�enanl A7ail Address Cily SlalelZip Phonc <br /> Eleclrical CoMractor Mail Address Ciry State2p Pnone <br /> �-�J,�I�C l��11����� ��)�' <br /> � <br /> S�ale License Number CoNrecl Price of 1NorY, <br /> ���/�/ <br /> Proposed Use of Building Con�act Person (Plan Review) <br /> (� � /n' n/y /, ` y/ .�j�p <br /> Description of Work to Be Done: _4��f� �/�� u` � N�7 / '�'�"�S —_ <br /> NOTE: WIRING IN NON•DW[LLINGS IS REQUIRED TO FEE <br /> B[ IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT I.00AL SALES TAX CODE IS 3705 <br /> I herrby certity(hal l have read and exarnined(his applicafion and know the same fo be true and L C-���-� (� -�i c'"� I <br /> correcL All provisions o�laws and ordinances govemmg fhis lype o(n�ork wdl be comp,eted <br /> whelher spealied herern or noL The�ranlinc�o/a pennif does nol prvsurno lo give aufhonty to <br /> violafe or cancel fhe I�rovisioirs o/any ofher state or local law regulafing consfrucfiwi or fhe <br /> perlomiance ol conslruction. That I am aidhorized b}�the owner o!fhis property to perlorm fhe <br /> work(or iahich�l�ion is m o and 1 comply�rilh the S(afe ConUactors Law 18.27 RCW and <br /> 296.200�gG� <br /> 7��"�f <br /> Sign ure Uate <br /> // �U <br />