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.'/ <br /> r . <br /> i — <br /> ELEG�RICAL PERMIT APPLICATION <br /> CITY OF EVERETT PER�UIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-`157-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> "fU � �� LJp ,^ � F , Wt�, Sv,��c � � �vGnrr. �L <br /> PROJECT ADDRESS <br /> � c�,� ��F 5�;,� <br /> Owner Mail Address City State2lp Phone <br /> I <br /> ��.V< Sh�A — <br /> Tenant " m�aando�ess ciry siaieiziP •�25-,,i7P_.)�)7�,ne <br /> < �� '" ��� 3���1 �, ��r��� <br /> � v a c.L. � � c c�r'e. 17 3� �,I 1 S/ �C <br /> Electrical ConlraCtof MaU Address Cily Slale/Zip Phone <br /> � �Ic,i� ��'2 `Z'� 1G� i � l nc,c�� <br /> Slale License Number Conlracl Price of Work <br /> o�k , L 4 <br /> Proposed Uso oi Building Contact Person (Plan Review) <br /> DeccripUon of Work lo De Done: Li��% c � � � �v �"��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3Y05 Uc�/ <br /> 1 00 <br /> 1 hereby cerii(y thaf I have read and examined this appi�cation and know fhe same to be true and V I ` � <br /> correct. All provislons o(la�vs and ordinances governing.fhis typa oI work will be completed <br /> tvhether specified herein or not The granfinr�of a permir does nof presumo fo give aufhonty to <br /> violato orcancel tNo provisions olany other s(a(e orlocallaw regulating consWcfion orthe <br /> perfomiance of construction. That 1 am aufhorized by the owner o/ihis property to perform fhe <br /> �vork lor which application is made and 1 cornply wi,h Ihe Stafe Con(racfors Law 18.27 RCW and <br /> 296.200 V✓AC. <br /> ti �' � �I 5 r��z v I � <br /> Signalure ` - Dale <br /> ,< <br /> �� �'5... � . . <br />