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( <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 FROA/9 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> ��a� �.�C�� <br /> PROJECTADDRESS <br /> K ��. ,�.9 a��.� �/ %.� �.�-,o �.� �.�� <br /> Owner Mail Addreu CIW/ Stale2ip Phone ' <br /> (% <br /> ,SO�i�e � <br /> Tenant Mail Addrass Ciry Slate2lp Phone 1 <br /> I <br /> .r/�v1� �,���t f��,:��,�,r P 6 ,[�,� t� '?�.��,s�„ //�i��F��� <br /> EletlnCal Contradof Mail dress Gty ale2ip Pbane <br /> �Gd�"3�1,i.3 _ <br /> , "l 9 r/G T' �7 acr7� <br /> State License Number Contrad nce of Work � <br /> .S�� �a�� ��»��, � <br /> Proposed Use of Building Contad Person (Plan Review) � <br /> e 9 �,� �/ <br /> Description of Work ro Be Done: �LJ'f?. O�f'� i:� ��i'L�i�n Lt:[.CL/ p� (�j rji���. <br /> NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br />' CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br />� I horo6y certily that I have raad and ea�amined Ihis applicalion and know the same lo be true and <br /> conecL All prov�sions o/laws and ordinances govemmg this type ol work wi/l be complefed <br /> whofher specilied herein o�not The granting o/a pormd doos not presume to give authonty to <br /> vio/a(e or cancel the provisions ol any other slate or local law regulating consfruction or the <br /> peAormanco ol constn�ction. That I am aulhonzod by the owner o/Ihis propoRy to peAorm!ho <br /> work lor which applicafion is mado and I comply wil (ho Slato Contrac(ors Law 1827 RCW and <br /> 296.200 WAC. <br /> ,l ,� <br /> ' �� .��..� .- ��-x / o <br /> Sig ure Oate <br /> / . <br />� EO't�l-13Z <br /> �(/it ���Q�. � ., h' � fGn o-�^ u�,J oi �-f <br /> �c �ce.�: � % <br />