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� � <br /> ELCCTRICAL PERMIT APFLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� �.a—/D <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> �/d �l�61DQ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> "�6r3S �ve�':;Icrn Inf�.� <br /> PROJECT ADDRESS <br /> ��l�r,b�r <br /> Owner � Mail Address City StateZp Phone <br /> � <br /> � C� H�r,Jwur�, <br /> Tenant Mail Address City State2ip Phone <br /> ��� Wti/s �/r/' �Clffc� /�/f t• �c�n14'I S'/. /accm�, wi9 • `IYi�O y �s�-3fS.T-77/� <br /> Elecldcal C ntraclor Mall Address City State2ip Phone <br /> Aiiw�r� c�oy�Q � �� � . <br /> State License Number Contract Price of Work <br /> CcC�++-Rf'S� �lt,..� 'l o I�7-t , <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriptfon of Work to Be Done: ( � ���� w�'�"S <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 here6y certi/y that 1 have read and examined fhis appllcation and know the same to 6e frue and <br /> correct. All provlsions of laws and ordinances goveming thls rype of work will be complefed <br /> whether speci�ed herein ornot. The granting of a perm�t does not presume to give authoriry to n <br /> violafe or cancel Uie rovisions o(any other state orlocal law regulaGng consfruction or the O�� <br /> performance of cons�ruction. That I am authorized 6y the owner of this property to perfonn fhe O <br /> work lor which appqcafion is made and 1 comply with fhe State Contrac(ors Law 18.77 RCW and I � <br /> 296.200 WAC. 01 � <br /> � I � - 2 - G �i� <br /> S�Ignat e Date <br />