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--. <br /> : <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wwv�.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> :7Z- � ,���'�-f�Gv�3'� <br /> PROJECT ADDRESS <br /> � l ' Z/l ZL/ v <br /> �u �G �G � ��JF.c ft,� Gc/aY f� � <br /> Owner Mail Address City SlatelZip Phone <br /> ��t.�u �tG36o f'v�,��f� Gr/�- �ir Liz .a � „ <br /> Tenanl Idail Address Cily Stale2ip Phone <br /> �',f /.Ii �`�',o�u �l�1. J�J. /�!f C' �,r�/G ��6� l l3 ��� o�G j- <br /> [leclrical Coniractor Mail Address City Slale/Zip Phone <br /> T� � F �°C' j ��y l� � <br /> State Licenso Number Conlract Price of Work <br /> Proposed Use ot Building Contacl P�rson (Plan Review) <br /> Description o(Work lo Do Done: �" � I�� � ��/m �7� �/' �2 ]� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> 1 hereby certify fhaf 1 have read and examined this application and know Ihe same fo be hve and <br /> conecL All provislons ollaws and ordinances governmg Ihis fype ol work will be cornpleted <br /> �rhef0er specd�ed herein or noL The granting ol a permd does not presume fo give aufhonty to <br /> �iolafe or cancel ihe provisions ol any other sfato or local la�v regu/atin�construcGon or the <br /> performan n(construc6on. Thaf 1 arn aufhonzed by the owner o/this property to perfonn tlm <br /> i+ork lor w h a� ic tion is made and 1 comply�vith fhe Sfafe Confractors Law 78.77 RCW and � <br /> 29G.200 Wq . <br /> � <br /> ����7� ,: ,�- ��� �• J�- <br /> SignaWre Dale <br /> ;���'y c;7) <br />