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-. <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 42�-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 35 � 5 - f� rz ° ,� Dvtl /aY <br /> PROJECT ADDRESS <br /> .'f--� M . 5 �l �1 N � 0 2 3 - �. (-� R ��a o�,T � ��;z-rr c��a �r'� z � 3 <br /> Owner Mail Address Cit <br /> Y State/Zip Phone <br /> I� � � G � l-, a R i; ,l�t D N I <br /> Tenant MailAdoress <br /> City State2lp Phone <br /> EleclricalContraCtor MailAddress Cily Stale/Zip Phone <br /> � !�, O <br /> .S R ��Y�. r �/ G� l� S c= �? Il i � c= --��' 793 -� l 7 <br /> State License Number Contract Price of VJork <br /> � A �3 k'� , � � 0 7 � r 3 , � �� <br /> Proposed Use of Duilding Contacl Person (Plan Review) <br /> ��'/L- L C-: ,-0 �c= <br /> Description oi Work l0 8e Done: �,C�}?�Qj'�Q�C� CL. �;Z'3Z2.�� ��;cj� -S� <br /> '��d'1-t�C �� <br /> �' t� '1.<-,� �/ "J'j'L CC�'� � tL� - .��1�''�' <br /> � � c <br /> _ 2 c�c°z=��-t- � 5 � �u-��� <br /> , , <br /> I 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 3105 <br /> I here6y certily Ihat 1 have read and examined Uiis applicalion and know fhe same to be true and <br /> comecL A/l provisions oJ/aws and ordinances govemmg this type oI work will be comp/efed <br /> whelher speci6ed herein or not. The granting ol a permd does not presume to give authonty to <br /> violafe or cance/fhe provisions o/any other state or loca/law regu/ating construction or the <br /> per/ormance ol construct�on. That l am authonzed 6y(he owner o/this�roperty to perform the (� <br /> work/or which application is made and I comply wi(h fhe State Contraciors law f8.27 RCW and <br /> 296.200 WAC. � XI <br /> �J <br /> C�� ; <br /> Signature Dale `�' � <br /> i - � <br /> %]-' ; <br /> �� <br />� - <br />