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a� -►b -��7 <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 - www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> - ,�' � � � � <br /> PROJECT ADDRESS <br /> �r )� � �. --------- --- -- <br /> Owner r.tn�nddie., c.l; simc'7ip Phana <br /> Tenan� Mail Address Cily State/Zip Phonc <br /> � irn,'1` �T �( i i '' ,` I( I;JI. E���.>� 'Ll.��T P� 4�v� `���111Ji,lr.�li (.J�� �-�G.� i :j7, _ <br /> Electrical Conlraclor Mail Address Ci!y Slale'Zip � Ph,one <br /> �� �l� ��lJ I <br /> ,� ,. ��11I C I /1 i�� ���_ " L ����r„-� . <br /> S�ate License Number CoNract Price of Work <br /> � ( !� <br /> <., _ <br /> ProposeA Use o(�uildinc� Contar.�Person (Plan Revlew) <br /> Descripliono(Worklo�eDnnc� -- � I-C 1�/�i,� �) �� I� � ;,•�.= (���� -�h1��� (_ <br /> 0 <br /> NOT[: 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 /> 1 hrioby rertdy thaf 1 hav�ren�l and exarnirrr_d fhis apphcn(ion end knrnv Ihe same tu be trne and <br /> r���nacf All prowsions o!la�vs anA ordinances�overmnp fh7s typo ol v�ork �vdl be complelaA <br /> �vhefha specihed hr.rein o� noL The r�ranbny o!a pernut does nof presunie fo give nufhonty fo 1 <br /> v�olafe or cnncel Ihe provisions o/any othe�sfafe or local Inw ror�u/ating consfruction o� fhe I <br /> per/om�anr.e ol construcfion. That 1 arn aufhorized by Ihe owner ol fhis property to perform fhe - - - I <br /> �rnrk lor which applicafion is nieAe and I coniply wdh fhe Sfate Controctors Law 1921 RCW end __ � <br /> 29G200 WAC. � . <br /> a <br /> � / "� <br /> _ �. •V '_'_____ ��1�� 1 �C.l � �j_1C� 1 <br /> SignaWre Dale � <br /> T��_ I .� �-, <br /> , <br /> �. <br />