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� � <br /> ELE�TRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-6857-www.everettwa.org 3_ t,�..bC <br /> f <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM ��D9b3-O� <br /> ��1 � 1� � � ����� ��� <br /> PROJECT ADDRESS <br /> �st i cc h l�tc� � ��t ov �� � �Y+h �- � q���o �I l�v u� � 'c�� <br /> Owner Mail Adaress City State/Zip Phone <br /> �;���� h�,.;��(�. � �-- 11't��Q �P i��i5 A� �� � �c;�r�� �� <br /> Tenant Ma�l Address Gity State/Lp 2_U�...� Phone <br /> ������ ��l�I �C ll� V � F---�/� I �C� 1..��.-�-1`l'�l.Y �� � :1��'J <br /> EleCtric0l COntractOf Mail AO res5 Ciry Slate/Zip Ph e <br /> �aaz�ao�=�� � g-�z 3 <br /> �u � s� IqQti�-1 � �U ! <br /> State License Number Contract Price of Work <br /> �-�'1C_� Y��-� l� <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description of Work to Be Done�. l �C 1�4.1� C1 � �D��r7 /� � � ��a C�� <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 3505 <br /> II hereby certily that I have read and examined this application and know the same to be true antl <br /> correct. All provisions of laws and ordinances govem�ng fhrs rype of wo�k will be completed <br /> � whether specilied herein or not. The granting o(a permR does not presume to give authority to <br /> wolate o�cancei the provrsions ol any other state or local law�egulating construction or the <br /> ' perfoimance of consfruction That I am authorized by the owner o/this property to p�rform the <br /> work for which applicaRon s made and I comply wifh fhe State Conhactors Law 78.27 RCW�ntl <br /> 296.200 WAC� <br /> i <br /> � /� <br /> ���� � Date�� �� L <br /> S�ature . / ) <br /> � � ��'S � <br /> � <br />