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f <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVEP.�TT PERMIT SEKVICES � <br /> 3700 CEDAR STREET, EVERcT'f, WA 98201 <br /> 4'15-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> � oS E C4Sinir �1' • /�• <br /> PROJECTADDRESS <br /> _�q ti,� .�f s •i r_rn .. h <br /> Qwnei Mail Address City SlatelZip Phone <br /> S ��i f� z S.\ fG1a �-. � �/Ar�nqcy <br /> Tenanl Ma�Adtlress City StaleRlp Phono <br /> �Crr� N[c : cc 7yao //QiliSo�✓ ?� �uc./( (,� 5�7� 5 r/rs-z76 •fr&sr <br /> ElecUical C lraclor Maii ACdress Cily Slate2ip Phone <br /> f' � � r., ,,,� ofirL � 3 /oo. "� <br /> Slate License um6er Contract Price o(Work <br /> I , Lo <br /> Propo ed Uso of B �dmg Contact Person (Plan R ew) <br /> Description of Work to Be Done: i �.�{� [� (/ ) L e U S . i o [ X t�i � <br /> .7�LT c .5�� _ <br /> NOTE: WIRING IN NON•DWELLINGS IS REdUIRED TO FEE <br /> IBE IN RACEWAYS, MC OR AC CABLE. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I hereby ceRif�fhat 1 have reaJ and examrned fhis applicatien and know the same to be true and <br /> correct All p�ov�srons ollaws e�d ordinances govermng fhis type o/work w�ll be completed <br /> wnether speciGed herem or nol. The granfing ol a permrf does nof presume fo r�rve authonty to <br /> violate �r cancel the prov�sicn � r,l any other stafe or locel law regulating co�strucfion or the <br /> peAoimance o/construcUon. Thaf I am aulhonzeAby the owner o/this prqierty to pedorm Ihe <br /> werk lcr which anAi�calion is made and I comply wCh the Sta�e Confractors _aw 78.27 RCW and <br /> 296.200 WAC. „ <br /> /� <br /> �/�^ �--.�-7 <br /> i�4' J �/./ <br /> s,`�,-i�re Uaie <br /> EoSo�-oc� <br />