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� <br /> ELECTRICAL PERMIT APPLICATI��N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-8857—www.everettwa.org ��,�A� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C���O�j�� <br /> � <br /> ��'f�' C! f=�6'E7•_'e�i'��ZTJ ���� <br /> PROJECT ADDRESS <br /> Owner MailAddress City State2ip Phone <br /> .f2 s- <br /> CI,uRHr�s� c.a���- L1l��J 6vc�'�•'/-'cta; t�ht/ f��Y'i7i- G�'1—� �/filc5 3c� �,•"�, <br /> TenaN Mail Address City Stale/Zip Phone <br /> Z)� <br /> {}�� �J'G-G�cl'I�T�� .�iL-"P—J�C.c� ll�L.yti� CQc'CK/�..i.•v� N �(OS- li:/7ftl-L �(.�'�' /L�C�/� 3���]-"1��'� <br /> EleclricalContfaclof MailAddress Ciry State2ip Phone <br /> ��7��ic��i.t��iLiJS l2G(.%. O" <br /> Slale License Numher Conl2ct Price of Work <br /> ��t`%� irz.x 'l��i-';�}�-111v� <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descnption of Work to Be Done: �n1�•rti"Ii�- �Z.0 i�,��c�SY 5 R�31 <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> I hereby cedily lhat I have read and ex�amined fhis applicafion and know the same fo 6e frue and <br /> wrrect. All provisions o(/aws and ordinances govemmg Ihis type o/work will be complefed <br /> whether specdied herein or noL The granting o/a permd does ncf presume to give authonty to <br /> violate or cancel the provisions ol any ofher sfate or/ocal/aw regulaling construction or fhe <br /> peAormance of consWchon. Thaf 1 am aulhonzed by fhe owner o(Lhis�roperfy to pedorm the <br /> work lor which application is made and I compty wifh the State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � c��� ��� � �, ���/ <br /> � � <br /> �Wre Date � � <br /> , <br /> �_ , , ,� <br /> �'� � <br /> v <br />