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� � <br /> ELECTRICAL PERMIT APPLlCATION <br /> CITY OF EVFRETT PERMIT SERVICES <br /> 3200 CF_DAP. STRE'�l, EVERETT, WA 98201 <br /> 425-257-8810 - Fr�,X42;i-�57-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ��L��i�1x\ IaV ' , Y' ryS,1N 1�lyL"3 <br /> PROJECT AD� <br /> ���r�11 �,c�1 D�,�� r`b Bc�.2r�i��s ��zre�t w� a�s2a3 l�+z��=;��cs-uc�� <br /> Cwner Mail Address Cily Slate/Zip Phona <br /> .�,a����-���, r ��,t�,� s��,.� 5��,�� <br /> Tenant Mail Address Clty Slale2ip Phone <br /> �r:�i,3-cz-1 t�cu.���C, 'L221 C�xl,�,r>>a� S} �JQXp�}' ` W1'-t ��?,U� (4LS� ZS�-34�5' <br /> Electncal ContrBctor Mail Aadress Cily StateRip Phone <br /> ��N I l"F--�:2j I 1.; F'� $ Z�4(n!'? . cn� <br /> State License Number Contract Price of Work <br /> '�� , � <br /> I�drnitl�StYY�tl�e. fl��: �C�`� � — <br /> Proposed Use of Building Contac Person (Plan Review) <br /> DescnptionofWorktaBeDone: IY�`'�\ �.,�Ct�-1C��"1 G� �L�W� �/���Llt�-�.. <br /> ��� Ll �t�LV '��� �J�-Q.1'� • <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> CITY OF EVERETT LOCAL SAI_ES TAX CODE IS 3105 <br /> I hereby certify that 1 have read and examined this application and know the same to be irue end <br /> correct. All provisions of laws and ordinances goveming this fype ol work�wll 6e completed <br /> whether specdied herein or not. The granfing o/a permd does r;ot resume to give aufhonty to <br /> violate or„ancel ihe provisions of any other stafe orlocal law reguPhng construcfion or the <br /> peAormance ol construc6on. Thaf/am authonzed by fhe owner c/this propeny to peAorm the <br /> work for which application is made and I comply w�th the Stafe ConVactors Law 7827 RCW and <br /> 296.200 WAC. I <br /> i�(�u�n ,����rl�c;-�-t� I I l�,o I o�l �� <br /> � ' igna e ate <br /> �� � � , � 5�� <br /> i <br />