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1— i8--�5 <br /> --- ---- -- -- � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREI"T, WA 982U1 <br /> 415-257-8810 - FAX 425-257-8857 — www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TG 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> . ; �! � � <br /> � � � O � �4tiL,� i �\�� �,-z . 3 /� <br /> 1 <br /> PROJECT ADDRESS '—r�1 <br /> i <br /> % ., � �� <br /> ��� � ��V(�� � ')C��/ 1�/�-� <br /> O�f� Mail Address Ciry � SI te/Zip Phone <br /> TenaN I Atldress .:ily State/Zlp Phone <br /> � 1�'SG��; G r { ,S �1.�,�� U �. 47�J� �'�E �`��11�j( vt L_ �'r / <br /> Electri al Con�ractor TMail Address City StaleQip Phone <br /> � ���� 2��. �� <br /> Stale Licanse Number r�, '� ' � /� (�y, �� Contract Price ork <br /> l, I u � . ` b .. <br /> / ' <br /> , �,�,� <br /> Proposed Use of Buildiny Conlact Person (Plan�view) <br /> /� /' �+ � , 1 � ` <br /> Uescription/of Work to Be D/on�e�. 1 ��I S c ir� ��-1 C ( Y L � ' � � ��U vU J . � ^ � `J � <br /> l/ / ' Ii � <br /> /� .`r�� -i..._ 4� � . . _ <br /> `_ <br /> iVOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS. MC OR AC CABLE -� ( � — <br /> I t��C� <br /> ��, CITY OF EVERE'fT LOCAL SALES TAX CODE IS 3105 <br /> �i I hereby cartdy that I have read and exammed fhrs applicafiun ,.nd knew the same fe be frue and <br /> � �.:orrect. All provisions o!laws snd ordmances govermng this type o/work wdl be completed <br /> ' whether specdreC herem ar nor. 7'he grenhng a/a permd dees not resume to grve authonty to <br /> � >iolate o�cancel the provis�or,g ol eny other sfate cr local IaH�reguPtmg consfruction or the <br /> ' peAormance ol c truction. ,"Ihat I am authonzed b��the owcer ol this property fo peAorm the <br /> � �verk lor which a plication is erle and i comply wrth fhe Sfate Contractors Law 78.27 RCW and <br /> I 296.200)p/AC. <br /> i' �z . _ � �� o � _ ��� I <br /> S n ,;r. �ate / <br /> i C Lf� � <br /> � <br />