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t * <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SE�tVICES <br /> 3200 CEDAR STREET, EVERETT, WA 95201 �,} ��,�> <br /> 425-257-8810 - FAX 425-257-8857 -www.everetlwa.org <br /> C-D�ra-o63 <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> ������ �n� c��a�►,�� �=�1 <br /> PROJECT ADORESS <br /> ; ���f,_� ' <br /> Ownef Mad Atltlress Cuy Slate/Zip Phone <br /> �t�V '�( . -1 � �0 1�oom �o�urnn I�l-��no - � -.:L <br /> TenBnl Mail Aoaress Gty Slale/Lp Phonc <br /> �- 1 , F -,Y'�� , 1 � � 2 - �- <br /> � <br /> Elect ical Conlractor Mail Atltlress I Cily Slale/Zip Phone <br /> r. <br /> �1�- - .�ll��1\� ) � <br /> tate icense Number Contraa Pnce of Work , <br /> ��r�a 1 fi � � <br /> ro osed se ol Bwl mg Contad Person (Plan Reviewl . <br /> Descnp6on ot Work to Be Done I � t �� � ` _ _ P �II <br /> )Y I J �,� L� � I <br /> NOTE WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE ' <br /> BE IN RACEWAYS. MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 �I <br /> I hmr,bY cw1Ay fhaf I have read and vr�rn�ned fhes aPPlicahon and know fhe same fo l.�e Irue and �/�� / � or ^�7 <br /> canocf All provisions o!laws and ordmances yovmning Ihis typo o/woik wiU be complefed �J � v!J <br /> whcfhm spoahed he�o�n or nof The gimrtin�ol a pt�nrul does nol prosurno fo 9�ve aufhonty lo <br /> v;olafc or cancol fho provimons ol any ofher sfal�or locol law rogulafmy cons6ucf�on ri fhe <br /> pr,Annnance ol consfiuchon Thaf 1 am aulhonzed by fho o�vnei o(Ih�s p�operty to pcdomr fho <br /> work lo�which appl�cal�on is arrd I comply wdlr Iho Sfafe Confiacfors Law IB 27 RCW and <br /> 296 700 WAC <br /> � "����.1/ ��,1 �I �( �/�� / , % L <br /> _. .. , ignaWic �a '. <br />