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---- -------�.— <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICFS (��br-n� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �OSO ��d� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> AF'PI.ICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS AR[ NOT ACCEPTED <br /> , <br /> i� � �' �-�— <br /> PROJECT R.DDRESS <br /> ���' ' --� ���-�'t �C._'. � �f[. i ' / r ��i/ i i '/a�J S�'� �' /L� <br /> Ownr.r Irtail Address City Slate2ip Phone <br /> Tenanl M1fail Address Clly Stato2ip Phone <br /> '/ • / '%.•`� <br /> / _ <br /> [lectrical Coniractor Mail AAAress Clly State/Zlp Phone <br /> Slale License Number CoNract Price ol Work <br /> ; '. — <br /> Proposed Use of Buildiny Conlbct Person (Plan Review) <br /> DescriplionofWurklo [3nDonc��. �/�! 'i/r.'/� / `jCl� h;'.'/' L/'.�� 1"/ ��. /ti �i��, /i <br /> / ! r-, / . . �� . / . j , <br /> Y - <br /> NOTE: WIRING IN NON-�WELLINGS I� REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> � I rrereby cnrtdy fhaf I have mad nnd e.aminFd fhis appOcanon end know the sorne to Ge frue and - -�� � ��` � ' � � <br /> �. .:;riecf. qll provisions ol IaH�s anA ordin.inces go��emmg fhrs f}�pe ol work wdl be completed - <br /> ��. �5lrofher speciliod hercin or nof The gran6ng o!a pernut doos nof presume to give a�thonty to <br /> �n,�/afe or r.ancel fhe provisions oleny orher stafe or local law regulahng construcfion or fhe <br /> . perloinrence ol construction. Thaf 1 am aulhonzed by fhe owner n(fhis property fo peAorm the <br /> �,vcrk/or which applicafion is rnade and I conrply wilb fhe Sfafe Contracfors Law 78.27 RCW and <br /> � ?96200 WAC. <br /> � � - � <br /> � _ � e <br /> .:I. ��, � y/' i � ik'� . , � '. " .'� <br /> i <br /> � Signalure Dale <br /> , !"� ,. ,� - i <br /> I_ ____. . .._ .___________. . .. . __—_.._.___--..___._.__ _— __ <br />