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r <br /> ELECTRiCAL RERMIT APPLICA�'ION <br /> CITY OF EVERETT PERMIT SERVICE� g_��vo� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857–www.evereltwa.org G—v70h�-1(�,5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 A^A TO 4 PM <br /> ��� lr/ � l/ � <br /> PROJECT ADDRESS ' <br /> ����'( �'j�i�-� rc�� 28 / Y ��Gr �vC' C �Pve �� C//� p� sZ� Z rc� <br /> Otv�e� Mail Addross Cily Slale2ip Phone <br /> Tenanl Mail Address Cily SI�Ie/Zip Phone <br /> ���,� au,e� � �P <br /> Eleclrical Conlraclor 1.1ai1 Address Cily Slatc�Zip Phone <br /> 3 p�� � <br /> , <br /> Slate License Numbcr Contracl Price of WorY, <br /> Proposed Use ol Building Conlacl Person (Plan Review) <br /> Doscription ot Work lo Bo Done: � I�'✓�"' ��� <br /> NOT[: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR A� CADLE. <br />,, (5 �_ <br /> CITY O�EVERETT LOCAL SAL[S TAX CODE IS 3105 <br /> 1 hereGy certily fhaf 1 have read nnd exnmined fhis npplication ond know fhe same to be frue�nd <br /> corrocL A/l provisions o(laws and ordinances qovcrninc�Ihis type oI�rork rrill be compleled <br /> H�hefher specified herein or noL The c�rantino ol a permd does not �resumo to gire authonf}�to <br /> violafe or cancel fhe provlsiens oleny other stafe or local lmv mc�u�3fing consfrucfion orfhe <br /> perlomiance o/construction. That I em authorized by thu on�ner o/th�s property fo peilenn fhe <br /> work(or which npplicnfion is ntode and 1 comply n-ifh fhe State Con6actors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �°-�.�' �' f� �, � d`''` Y"`' .l"- <br /> � Sig�urc oate <br /> ���oa ��S <br />