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! � . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERV'ICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org 6--�.���� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TQ 4 PM E 1!D b�17 3 <br /> '�6 l0 �vF,����F��� �-�- <br /> PROJECT ADDRESS <br /> �hf �� c�c L� C � �' �Gx ��� �` ,vluh��@ �I�Z.7 � <br /> Otvner Mait Address Clty State/Zip Phone <br /> �rn'' i v'h �G1�E� <br /> Tenant Mail P.ddmss C(ty Stale2lp Phone <br /> �v�''c� �c1ec�'r�� 173� G�IY-r� � SC ���^o�� 1r15 °l�Z� <br /> Electrical Contrector Mali Address Ctty Slate2tp Phone <br /> '�vkc�.0� 2^�jlC'P� `� � aad <br /> State License Number Contract Price of Work <br /> � �,h�p � 3U1q71' <br /> Proposed�se of Buiidfng Contact Person (Plan Revfew) <br /> Description of Work lo Be Done: LhA+-�c G , G,�� ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/y thaf 1 have read and examined this application and know the same to be frue and �I 1 U�- I � 3 <br /> correct. All provlsions of laws and crdinances goveming thls type o/work wi116e complefed <br /> whether spec!lled herein or not. The granf(ng of a parmif does notpresume to give authority to <br /> v!olafe or cancel fhe provisions olany other state or local law regulating cons(ruction or the <br /> performance of constnrcf(on. That 1 am aufhorized by fhe owner o/thls propeRy to peAorm fhe <br /> work for which application!s made and 1 compty with the Sfate Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �- �-��;` ��2� �z� ,� <br /> Signalure Date <br />