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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERET'T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 1_1 �-OJC <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 651� `��7 <br /> ! � � � l� iiL' 1 r �'�-il 5i <br /> PROJECT ADDRESS <br /> .S �• � tf�1�� �' If'l,'v � �� fJ-1_/� �iC�'iy` <br /> Owner MailAddress Cily Slalc/Lip Phone <br /> Tonanl Mall Addmss Cily Stale2ip Phone <br /> n.f � [,i��-V /=cfc �,�� � �� �, � r.,� � <br /> El�c�riCal Conlracl� Mail Address Clry StatelZip Phone <br /> /l.� C �, ! /`✓' i�: L G C� i I�/ j <br /> Slate Liconse Number Contracl Prica of Work <br /> ,;f S D r.,`$�'i''�e X <br /> Proposed Use ol�uilding Contact Person (Plan Reviow) <br /> Descriplion of Work lo�c Don�: �� ��� Iv'!-bV� / /: �� - l� U r�k <br /> .ti - /G(`. /� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceri�ty fhat I have read and exmnineA Ihis npplicaGnn and know fhe samr, fo be fruo end <br /> conecf. All p�ovisions ol laws anAordmances governmc�this type ol work will be completed <br /> �rhefher specilied hcrein or nof. The gianfin�o/n pnmut docs nof Uresurne fo give authority lo <br /> viulafe or ce�ncel f0e fnovisions o/any olher sfafe or locnl Inw�egu/nfin4 consfruc6on or fhe <br /> perlorrnm�ce ol consfiuction. Thaf I am nuthorizeA 6y Ihe owner o!Ihis pmperty lo per/onn fhe <br /> weik lor which npplicalion is maAe and 1 ror�iply wifh fhe Sfafe Confracfors Lnw 1827 RCW and <br /> 296.200 WAC. <br /> . i <br /> � "�� l%- Z �' - :: �� � <br /> yc�n— a�--� � i� Uaie �� <br /> � � I � � <br /> �� � ' <br /> C�/ � <br />