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_-� <br /> ELECTRICAL PERMIT APPLICAT�ON <br /> CIfY OF EVERETT PERMITi SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982�1 <br /> 425-257-8810 - FAK 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM A AM TO 4 PM <br /> -� � ' <br /> �; �� LU�-r.�_� •.,' � ,� . � <br /> PROJECT ADDRESS <br /> i� � � , <br /> ll ; � )r_ %. ,.: � (,_ �( =rc�� li,.�,� ;���,� �-. 4,- :! -/', ' , l�r r�;iJ� '� �' 7ic��J <br /> Owner Mail Address City State/Zip Fhone <br /> Tenanl Mall Address City State/Zip Phone i <br /> EleClriCal Conirador Fd�nl hddress Cil� Statc'Zip Phone <br /> Slale License Number Conlracl Price of Work <br /> Proposed U:•e of Building Contacl Person (Plan Review) <br /> Description oi Work lo Bo Done: �1 r i�l,��� C-1��_i_ � 1'I L U� L"hj�G�' ` <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />� 6E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi/y ihaf I have read ond examined this applicafion and know the seme M be frue and <br /> corrncf. All provisiais ol/aws and o�dinances goveming fhis fype of work�ti�ill be completed <br /> whe(her speci(iod herein or nut The granting o1 a permif does ncf presume fo give aufhonty ro <br /> violafe or cancel fhe provisions o!any other sfate or/ocal law regulating cons(rucbon or the <br /> perfortnance o/consfrucflon. That 1 am aufhonzed by the ownor oi flus property io perlomi fhe <br /> work lor which applicaflon!s medo and 1 comply wifh the State Contractors Law 1827 RCtN and <br /> 296.200 WAC. <br /> i,1 %� %� , <br /> 'l � � ' �' �%t i <br /> , ,_, <br /> ^ Siqr�aWre . ata <br /> �v��'��5 � <br />� - --- <br />