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y/ ` <br /> 1 <br /> .. �� <br /> ELECTRICAL IPERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES /�. /� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I/�/ '-�% A <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org /����� �(` � <br /> �� r � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> J�1 ��etc�eee�v '�1ay ��r� �� �1����j <br /> PROJECTADDRES <br /> cl) C�GKSOn ) � � : )I�`P,� <br /> Owner MailAddress Cily State2ip phone <br /> i <br /> Tenant MailAddress r,�r,,�ity �� ���. �,State2ip ph�on�e / <br /> 11,� � d`-/`1 1 ��C' � J�{�' S(i I <br /> 1�r�1���•eh{--\ J��O��i (�r� �k�����J} �1-�r�fi�r:�1�1 ��]J2�, '� ! <br /> Electrical Contractor T Maii dr ss Ciry Smte2ip --� Phone � <br /> rn(�-� � r D{��O � 1— �.�)� ii <br /> St te License Number Co Uact Price of Work <br /> � <br /> ����"{ f. I�����Q 1 <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> � � . � r <br /> � <br /> Description of Work to Be Done: <br /> l. C�3 � C3 ���t..(PL4f� <br /> V I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certi(y fhaf I Bave mod and examinod this application and know fhe same ro be truo and �� 1 ' _ O� [, ` <br /> crormcL All pmvisions ollaws and ordinances goveming fliis type o(work wi/l be completed F `> �� <br /> whetherspea6ed herein ornoL The granling o/a permd does not �esorne to give aufhonty(o <br /> violafo orcancel the provisions o(any other sfale or local law reguPfing construcfion or fhe <br /> peAomiance o/consfnichon. That I am authonzed by(he ownero(this proporty to pedorm Ihe <br /> wodc Ior which applicalion is made and I comply wilh(he Sfate Conlractors Law 18.27 RCW and <br /> 296.2 0 WA . <br /> . <br /> —` ( � Q <br /> ignat� Date <br />