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l <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 8 AM TO 4 PM <br /> `�CCi� �Jl'..�i C.t�:l�:,�cL �'� — �b- I�@ ,�1 �-t� <br /> PROJECT ADDRESS <br /> �cti��v�. l.�'�Cf-L-7 l.Jf� <br /> Ownef I.tail Address City State/Zip Phone <br /> Tenant hlail Address Clty State/Zip Phone <br /> �r�(� <br /> f U�� -�-•vt�-t`�1�\�L ��,' ivw �`���t ���Z:[. Wft �$� `�37-(�15D <br /> E�edrical Conlractor ti�aii Address ��� '��$ ciry State2ip Phone <br /> TI']�l il�ll� C(�\��N � ��.C�a.) c <br /> Slato Liconsc Numl�er Contracl Prico o(Work <br /> Proposod Uso of Building Contact Person (Plan Roview) <br /> Doscriplion of Work l0 8e Dono: -+�.£�Z I�C.L ��:.iC�� ���N`-�TC:�LW�K � �I.C,C�a (� <br /> �i,�.>l_;�� _ ., ,�x��f1 ���� <-iA,v� :�yLr.�S I� �-v--.5"�L..�C,�� <br /> NOTE WIRING IN PION-DWELLINGS IS RE�UIRED TU FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 <br /> 1 hereby certdy lhal l have road and examined fhis npplicafiun and know tho same to be fiuo end ����� 1 �� 1 �� <br /> roncct. All provisions ollaws ond ordinancas c�ovoming flis type ol work will be completed <br /> wheUior spocilied herein or noL Tho granting oI a perrnrt doos nof �esurne to give aufbonty fo <br /> violato or cancel the rvovisions o!any ofher s�ato or local law reguPaling construcbon or the <br /> peAormance o/cons(rucfion. Thaf 1 am authorized by tho owner o/fhis proporty fo peAomi fhe <br /> work lor which uppli�ation is rnaAe and I comply wi(h fhe Stafe Confracfors Law 18.27 RCW and <br /> 236.200 WAC. <br /> " - ..J �.,�y_ ,. <br /> ,. 1 � � -��{ <br /> SignaWre Date <br />