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( � <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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �/ 0�— �/PYQ 1�F�_I�✓/.S� <br /> PROJECT ADDRESS ✓ / <br /> `�v�d k��,.� 1.�, c�Z �,o� �.r ,e�� ��,�-� l'7r3�3 Zeh-69z: 9Sk� <br /> Owner Mail Address City Slale2ip Phone <br /> _�GV� Xi� r/ <br /> Tenanl Mail Address City Stale/Zip Phone <br /> ��e.lv �o, 4 /9i L-�.n� �-r' � i�n�, � o( � 9�03� <br /> Ele lrical ontracl� MailAddress �— � Cil �te/Zip Phone <br /> S`.��aS�k' q2� t� q -�- <br /> Slat�+License Nu iber�^� Contracl Price of Work <br /> Proposed Use of Bullding Conlact Person (Plan Review) <br /> Descriplion of W ork lo Oe Dono: Irti���?�� � G✓U�( �,'1��yl P� �=�S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF C-VERETT LOCAL SALES TAX CODE IS 3705 <br /> I heroby cerlily fhaf 1 have r'ead and examined fhis application and know fhe same to be true and I <br /> correcL All provisions oflaws and orclinances govemmg thfs t}�pe o!work will be complefed .\,b <br /> whether specified herein or not The�ranfinc�o/a pennd does nof prosume lo give au�hodty to �)j/ <br /> violafo or cancel fhe provisions oI any ofher state or local law regulaling construcfion or fhe <br /> peNormance of conslrucfion. That I arn r�uthonzed 6y fhe owner ot this properiy to nailorm the U <br /> work for which application is mado and 1 comply wi(h fhe Stale Con(racfors Law 18.. RCW and <br /> 296.2001NAC. /� /) <br /> �_...-�\j_ _%_C ���— 7"/7- � 5' ���) l « <br /> �—��re� Dato � <br />