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{ � . <br /> ELEI�TRICAL PERMIT APPLICATION <br /> CITY OF EVERETT '�ERMIT SERVICES �b_►9 -�/ <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org E' I'��0, <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 5 �Z � �v ���� e�,� ��� <br /> PROJECTA�DRESS � (, Zsj <br /> � <br /> Iv \c.�L \lCv�nDV�o-IGO�j � ��I _ �0�� <br /> Owner Mail Address City StatelZlp Phone <br /> Tenant Mail r�ddress City State2lp ���\��rPh�/�S_ <br /> ��,.k �..d GI�..�nz �361�i M�lc;��-eo Spd�y 5�;�� b�5 �30> �-Yk�w�d fY0�7 J - <br /> ' Stale2l Phone <br /> Electrical Contraclor Mail Address City . P <br /> ��� �r��� �u �s ��r� <br /> Stste Licgnse Number Contract Pdce of Work <br /> �Cb��h'i �i'N�f' . <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descripllon of Work lo Be Done: h�� � �) L��`�� '" � �-�--' '�F''� a'^r.e 5 <br /> � <br /> NOl"E: WIRING IN IVON-DWELLINGS IS REQUIRED TU �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this applicafion and know tfie same fo be frue and <br /> correct. All provlslons o(laws and ordlnances goveming thls type o(work wlll be complefed <br /> whether speclfled hereln or noL The granling of a permd does not presurae to glve aufhonty to <br /> violafe or cancel tlie provisions ol any other slafe or local law regulating construction or fhe <br /> perfomiance of construction. That 1 am eufhorized by fhe owner of this property to perform the <br /> work for whlch applicafion is made and 1 comply wifh fhe State Confmc(ors Law 18.27 RCW and / <br /> 296.200 WAC. � ' /U I�/l� /I' U - / D <br /> _� � � <br /> Signature Dale <br /> -�// ���Y>/ J <br />