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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMI'T SEi2VICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 � _�3 —l'�. <br /> 425-257-8810 - FAX 425-257-8857-ww�v.everetlwa.org C ��g��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM <br /> ��'� �cfoy � - <br /> PROJECtADDRESS <br /> �1b�5ftu �G�� ��ZO Ld�('JN�L �•lre.1�-tf" il.bt- 987..� 4�h33�-Ci�:�; �- <br /> O�mer Mail AddreSs � �°y "" <br /> Tenant <br /> Mail Address Gty Slale/Zip Phona <br /> � eofi� C� .S?� f IuaNSF W�A'1✓Ue c..e�TYL72 N�'W'L-'�� oL <br /> Eleclrical Contradoi <br /> Mail Address Cily Slale/Zip Phone <br /> �,,�� �q .� 7j�71--• a'°- <br /> �[t{�11�2-����� <br /> Slate License Number Conlrect Price ot Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �..y� ^I-,,,�,, � <br /> Description ot Work lo Be Done: �� ►"� �d Q�S ''"'A� `�,G � <br /> NOTE: WIRING IN NON•DWELLINGS IS REDUIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. Gy�� <br /> ��v <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i hereby certily that 1 have read and examined fhis applicatiai and know Ihe same(o be lrue and � �n O Q� O� I <br /> conecL All provisions ollaws and ordinances povernmg this type ol work will be complefed �� U <br /> �vhether spacilied herein or noL The granfing o/a pemut dues nol presume lo give aufhonty fo <br /> violate or oance!Ihe provisions ol any ofher stafe or local law regulafing construction or fhe <br /> peAormanco o�consfrocfion. That 1 am authorized.by Ihe owner of this property to perform the <br /> nrork!o•which applicalion is made and I compiy wdh the Sfate Conhacrors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � <br /> Signature 18 � <br />