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�3 -3 ��ou <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.evcrettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> /���(, � [� Si�n�C) //C.l� � — <br /> PROJECT ADDRESS <br /> , . <br /> ���,, , 1� 3 ��`I � C�,S,�+ ���'. ���� ��1-'�-- <br /> Owner Mail Address Cily Stale/Zip Phone <br /> ��`v L-� <br /> Tonanl Mail Address City State2ip Phone <br /> � 'I/ C C�Nc�fvi2 �It�_I (/,3�.k�v ..f I ��1�/yt (��,fi �j�2 ; l� <br /> Eleclrical Contiaclor Mail Address City Slale/Zip Phone <br /> � ��n �.SCC� '�dr� 6O � _ ;, ' �/vc,� , �, ✓ <br /> Stale Licenso Number I . � I' Conirect?rice of Work <br /> '� <br /> ProposeA Use of Building Contact Person (Plan Review) <br /> Description of Work ta Be Done: _����[��t/,� c. T�7� C� <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COUF.IS 3105 <br /> i � herehy certity that I have rcaA and exanuneA tb�;application and know fhe same fo be true and <br /> ��n.rect. All prcv�sions ol laws and orc�iaqces 9�n�erning fhrs type ol work will be complefed <br /> � whr,fher specdieA herein or not��jra Nrng ol a pennrt does nof presume fo give aufhonty to <br /> �i vrolafe or r,ancel Bie prov�siojte ol any ier stafe oi local law regu/ehng construction or the <br /> I ��erformance o!cgAs � . That 1 authonzed by fhe owner ol this property to perlorm the <br /> �vork for whict+�pplica(K1n�s nad .nd I comply wRh fhe Stafe Contrectors Law 19.27 RCW and <br /> ; 79fi200 WAC. <br /> ; _ � �-� � 7,�� _ <br /> � i Si Da�e <br /> � <br /> � ./ , ��pb "14G' <br />