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- — ---- -i <br /> -- --- ---- — - — � <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-v✓v✓w.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> a�a�� �� ���� �,�..��.� �� <br /> PROJECTADDRES <br /> t '������ ��,� ��� C�i�U �,,� ��eXp.� ��- n Iq <br /> Owner Mail Address City Slate2ip Phone <br /> C/'111n <br /> Tenant PdailAddress City Slale2ip ^� Phone <br /> d <br /> c IV I - c _``.r C� '�R�Q � OiS Y(�14f `Y1 UD c�'QTt�e W� 4g�`-'i"I ,��' '3da� <br /> ElectriralConlraCtot MailAddress �— Ciry Slate/Zip Phone <br /> � I �/��I(��� ��� � <br /> �YYIL- Z I.JS� �(o(�Dl3 _ —1/—"` - � <br /> iState License Number Contract Pnce of Work <br /> Proposed Use ot ui!ding Contacl Person �Plan Review) <br /> ' � � c� Jr- �.,��r k � � ��e �elleo- I �'r1,� <br /> � Description oI Work to Be Done: ,�_CQ,L �1�71/(1" <br /> I <br /> NOTE: WIRING IN NON-DWELL�NGS IS REQUIf2ED TO FEE <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> I�, CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> �I I haroby certdy thaf I tiavo read and e.rammod fhis applicatron and kno�v tho same lo be true and ��111_ I �� <br /> conect. All provisions ol/aws and ordinances govemrng fhis type oI�•ork will be completed <br /> I �vhether speci6ed herein or noL The granting ol a permR does nol presume to g�ve aulhonty to <br /> � violale or cancel fhe provisions ol any ofher slate or local law regiJa6ng consfruc6on or fhe <br /> �� performanco olconslruchon. Thaf I am aulhorizeAby Ihe owner o/fhis property to perform Iho <br /> I work lor which app6cahon is made and 1 conrply wrth fho Sfafe Con6actors Law 78.27 RCW and <br /> '� 2g6 200 WAC. <br /> I� � -"_— - /��s-a��� <br /> i �;7 . <br /> `-SlgneWte--1 Date <br />