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; <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � _6_p �' <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> C o507-00� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `�.�� � ��,- 4��<LC 1� �` \��. L <br /> PROJECT AD6RESS <br /> � � �- vr �t �>��V �_ ( \ � C , � �� � -�t-�I"Lv <br /> Ownet Mail Address City State2ip Phone <br /> _ � �-1 <br /> Tenant Mail Address Ciry � Stale/Zip Phone <br /> �l`�V�V L'C �lvv���r � � � �\C �. �` �'�'�Il"-S1� �a �G �`�� � �: t �� l�� ` _ :,� <br /> Efectrical Contractor [vtail Address Z = City State/Zip ?hone <br /> � � f� C� ��: �� �C - <br /> 1�`�i��. �. � r �i ,�cl �_ ����� ;�� -C '�� �- �, 1 C' � �=� � <br /> , <br /> State License Number Contract Price oi Work �� <br /> � <br /> ��� "� ` . C � • `. ���� � `- ��t�•_� '�\ ����i��� �� <br /> Proposed Use ot Bwidiny �Contac(Pe on (Plan Review) � <br /> Description of Work to Eie Done: �� {= ��`���� i ��� � ' ,.. � A� � ��'. �-�-���r . �,�C�< .� -�. � <br /> � " � �� 1-�, ��, t , A . � ,���� _ � l ,,. � � AZ_ �� <br /> ., � l �t���l ��.�� l_�` �{_ � �_��_ �,�7-� r- �,. cY��� <br /> � � �_cc ��, <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE —i { <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �. <br /> � <br /> I hereby certi7y that 1 have read and examined this applicalion ond know Ihe same to be true and ��� � U � —C.��i I <br /> correcL All provisions o/laws and o�dinances goveming this type of work wrll be cempleted <br /> whether speci/ied herein or noL The granting of a permd does not presume to give authonty to i <br /> violate or cancel the provisions ol any other state or loca/law regu/ating construction or fhe <br /> performance c, construcfion. That I am authonzed by the owner o/this property to periorm the <br /> work lor which application is made and 1 cornply wifh the State Contractors Law 1817 RCW and � <br /> 296.200 WAC. � <br /> t-�-k �� - _ '1 ( �. <br /> � / � . � �,- � Q ��. <br /> \ � ` � <br /> � Signature .� Date ' <br />