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c <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,everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> , � i- /i' ,--� <br /> -rl r� o� C�:i� C�/,'<',...F-� �Cc� <br /> PROJECT ADDRESS <br /> i� , � � <br /> � � , <br /> /.�-���.�z �i,.�,✓� ��v �- .i<,� ✓�,�.vr� l�A �'�a;; -. 4 )h�; ay�� <br /> Ownef Mail Address City StaleZp Phone <br /> Tenant Mall Addrasa Clty Sta�e2lp Phone <br /> ElecMcal Conlractor Mail AdEress Clry Stata/7Jp Phona <br /> State License Number Contract Price of Work <br /> Proposed Use oi Building Contact Person (Pian Review) <br /> �--` � <br /> Description of Work to Be Dane: /C,.�J ��.,_,�� -�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �,�, <br /> CITY OF EVERETT LOCAL SALES TAJ(CODE IS�105 <br /> I hereby certily thaf/have read and examined this applicatlon end know the sama to be fiue end <br /> correct All provis�ons o/laws and ordinances goveming fhis type ol work will be complefed <br /> whefher specr/ietl here�n or noC 7he granting ol a parm�t does notp resume to give authonty fo <br /> wolate or cancel the proNsions ol eny other sfafe or local lew regulefing consWctlon or the <br /> peAormance o/construchon. rhat I am aufhonzed by the owner o/th�s property to peAorm fhe <br /> work/or which�applipation is made and I comply wdh the State Confrectors Law 18.27 RCW and <br /> 296.ZOO WAC. - <br /> i <br /> /��. �<� �/��l- //- �-��✓ <br /> Signature Dale <br /> L o -�// -D/9 <br />