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� r <br /> f <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� I���� <br /> 425-257-8810 - FAX 425-257-8857—www.evereltwa.org / <br /> �////-//� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� i � c���.i 2�� . <br /> PROJECT ADDRESS <br /> �o �,�c�U ' e� Cuntr ci<�� s 5�'� NnrbecK Ave Cue,crf �n 9bLa3 <br /> Owner Mail Addro�s City Slate2lp Phone <br /> Tenenl Mail Addrese Clly State/Zip Phone <br /> Eleclrical ConlreCtor Mail Addreas Clty Slate2lp Phone <br /> ,� /SO �v <br /> Stete License Number Contract Price ot Work <br /> � �= IZ <br /> Proposed Use of Bullding Conlact Person (Plen Revlew) <br /> Description of Work to Ba Done: `� U�P At� 1 �S ar ��x-�-�..c s + _„si+�ll Si�oke <br /> (,�Q E-PC i-c+ 5 <br /> NOTE: WIRING IN NON-DWELLINGS �S REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heroby certily fhef I liavo read and exemined fhis appllca0on and know fha seme fo be frue end <br /> corrocf. All provlslons o)/aws and ordinances goveming fhls type ol work wlll be completed <br /> wliether speclfled lierein or nof. The granf(ng o/e pemut does nofp resume fo glve eufhorffy to I <br /> vlolale or cancel flie provlslons ol eny oflter sfafe or local lew regu/eting consfrucUon or fhe I <br /> eAormance o/consfructlon. Thef 1 am euthorized by fhe owner o(tlils propeAy fo peAomt fhe �� <br /> work lor whlch appllcvfion Is made anA 1 comply wlfh fhe Sfafe Contrac(ors Law 18.27 RCW end �(�� <br /> 296.200 WAC. � �` L <br /> �% <br /> � �//G (/ <br /> � oe�a <br /> Slgnature <br />