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( . <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—www.everettwa.org (o �-�"� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO d PM C �ld b-� b� <br /> �l� I o ��U�� �c,JPy <br /> PROJECT ADDRESS <br /> Owner Mall Address City Stale/Zip Phone <br /> ��i o c���n� c.��y ���2�- <br /> Tenant Mail Address City State/Zip Phone <br /> 1 �(ZS <br /> ��[�2c��r �/G Sa�( IR��'S�S� Lr.✓„c�� o �d cJ,,O 9� G69-8s� <br /> Electrical Conlraclor Mafl Address r City Stale2lp Phone <br /> �'N�932 N� �`�zz�o-�' <br /> Slate Ucense Number Contract Price of Work <br /> �I�V'kLX��- , �� <br /> Proposed Use oF Buflding Contact Person (Plan Revfew) <br /> Oescriplion of Work lo Be Done: �l�I �I C (n 17 �. 5���� ,Df �� <br /> �U1! � o U� 1�1,47 �1 6� //6� �6�ai <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CASLE. <br /> �a . ia <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily that 1 have read nd examined thls applicatlon and know the sanre to be irue and <br /> correct. All provJsions of/aws d ordinances goveming this type o(work will be completed <br /> whefherspec!lied herein orn t The grenting o(a permit does not�resume to give authority fo <br /> vlolafe or cancel the provisi o(any other state or locallaw reguleting construction or the <br /> performance of construafio . haf 1 am authorized by the owner o(th?s property to perform fhe /�, <br /> work for whlch applica s ade and 1 comply w(th the Sfate Contractors Law 18.27 RCW and / O� _/Cy� <br /> 296.20U WAC. � � / <br /> ij� <br /> � / �/� 7�'�/ <br /> �� Si Ure� ' Dale <br />