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� � <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 B AM TO 4 PM <br /> a�U z� GcJ �,z�. y � � , <br /> �--� ��J.'_,� � .1 '� ., :, �':" 'J�1 N, '' - ,'� �-4 i �-� � <br /> PROJECT ADDRESS <br /> �GZ n ``T�fl n � — <br /> Owne� MadAddmss Qry Stale.'ip Phone <br /> � n � ` <br /> l �ri''C—itr"t'�*-T^�' � c^-T'�ri� <br /> Tenanl Mml�ddress Ciry Stete2'p Phone <br /> �, �,.r�� _ '�� �'��� A�,I r� 'iQ i(e�c -� 8i�i <br /> � �r��� -�1�1Y ��� '����. �11��1 ', . ./I I �t� �1 .` ,4-LI� ��_ � <br /> EleciriC21 Contrac�or Mail Address Qty S:alelZlp ' Pha� <br /> I c04�) �131 • 3�5'� <br /> � � rl.c T� 4�s �� � ,�`I �'i ?Z <br /> State License Number ConVact Price of Work <br /> :�11t�l��ll+ �l�i �� <br /> Proposed Vse ol liudtl�ny Contact Person (Plan Rewew) <br /> DescnpUon ol Work to E3� flone � �1 '� <br /> NOT[ WIRING IN NON-DWELLINGS Ig REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I herc�by certAy thaf I have reaAnrrd warnme,d Uris apphcahon�and Mnow fb�sarne to he true nnd <br /> ��nrroc( All provisions o�I;��vs anA orAmnnces qovnming flus fype o�work wiU he carnplefad <br /> �:hofha specdied hwem or nof Thr,granhng o!a perrnd dor,s nof/nesume fo give aufhonf7 to <br /> viulaf�nr cancel fhe prov�srons o/nny ofher sfafe or bcal law regu ahn9 consfruchon ur the <br /> pr.rfonnance ol construcl�on Thaf I am nufhonzeAhy the ownor o/tlus p�operty fo peAorm fhe <br /> �vn�k lor wluch npplicahon rs made and 1 cornpty�vrth the Sfafo Contracfors Law 18?7 RCW and <br /> }'96 200 WAC. <br /> � <br /> (' . 1 �' �,��ti (�._ �1 � �.�,(o �. _ _ <br /> Signa�urr -nte �• <br /> �'�. i <br />