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�- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982ui �-I b"� 7 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org �D�O��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> S �� � �-� ro cd� wu� <br /> , <br /> PROJECTADDRESS q�r .�9� <br /> I��1 ��F 5 ��� ���tia� ���' w ,�— i �l� 3�}l6 <br /> Owner Mail Address City Sta1e/Zip Phone <br /> Tenant Mail Address Cily Slate/Zip Phone <br /> EICCtrical COnlraCiOf fdail Address City Slale/Zip Phone <br /> Stale License Ncmber Contrad Price of Work <br /> Proposr_d Use of Building Contac�Person (Plan Review) <br /> ����e( L�1��I� y�- l� � cr��'� <br /> Description o(Work to Be Done: ` " <br /> NO1 E: �NIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAf3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriity fhaf 1 havc-read and exarnined fhis applicafion and know fhe same to be true and <br /> correcl. All P��ovisions ol laws anA ordinances governing this type ol work wi/l be complefed <br /> whefher specified herein or noL The granting ol a pernul does nof resume fo give aufhority to <br /> violafe or cancel fhe provisions olany other stafe orlocallaw reguPfing consfruchon or fhe <br /> perlonnance o/cons�rucliun. That I am aulhorized by Ihe ow�ner ol ihis propedy to perlomi fhe <br /> work lor which applicafion is made and 1 comply wifh fhe State Confrac(ors Law 18.27 RCW and <br /> zss.2oo�vAy <br /> � �7 ` �6 - � `� <br /> ignaWre � _ Date l� <br /> � �� n.� � <br /> ��� I <br />