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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CCDAR STREET, 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 /> , � � � � / <br /> �,�r �' -� �,5 ��`�l)F').? .rf ,F�.� �, <br /> PROJECT ADDRESS <br /> Ownof Mail Address C�:y Slale/Zip Phone <br /> Tenanl Mail Address City Slate/Zip Phone <br /> ����w-0.���eC �'LC r����'� /C`C11�6rt�F El�c-,��"�f �r4. c��:,�.,f:>`>�Z��,�(,; !!� � <br /> Eleclrical Contraclor Mail Address City Slaleilip Phone <br /> / n <br /> !,. �% •�r� •�� �� � �l ') ` � I)� <br /> State License Num6er Contract Prico o(Work <br /> < �� � <br /> � � � <br /> Proposed Use of Building Contact Person (Plan F.wiow) <br /> Dascriplion o(Worh to�c Donc: G l i!��'_ P ��-=�:''-`- �S� ��. (�C�[�� �� � � <br /> NOTE WIP.ING IN NON-DWELIINGS IS REQUIRFD TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS J705 <br /> I hereby cert�ty fhaf I hnva read and exarnined fhfs applicafion and know Ihe same lo be frue and <br /> caner,f. All pionsions a/lan�s and o�dmances govc�m�nq fhis type ol work will be complefeA <br /> whefher specilied herein or nol The g�mrtm�ol a pe�mrt Aocs not presume fo�ive authority to <br /> violafe o�cancel Ihe Ivovisions o/anp other state or locnl law regu/ating conshucfion or fhe <br /> perforrnanr.e o!consf�uc6on. Thaf 1 arn aufho�iz�d by the awner u!this pwperty fo peAomi fhe <br /> worn for which applicabon is niaAe and 1 cornply wifh thc Sfafe Confracfors Law f827 RCW and <br /> 296200 WAC. <br /> ��8 \� ��.�i .,�1:�L. �l tJC L` � ,_/_ <br /> i S� natwe Date <br /> �/ <br /> � v � / /' / -� L,=, <br />