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i � <br /> I <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 /> 1//i� ��R(sR��,� w�� �'A <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/7Jp Phone <br /> �7�F10 �✓E,Q ,J'3ME 9 fSo✓� <br /> Tenant Mail Add;sss City StaleZp Phone <br /> C�R��f W�1�1 �c�c�R�c /^�C 65�3 3/ 5� � �E 5 Sefc*st� <v.� f�'�'� (�oGJ£jB-?i6 <br /> Electrical Contraclor Mail Address City State2ip Phone <br /> �/1G-"HTA/c` /�'.S��F C (j' '� a�,S�U() <br /> State Licenso Number Contract Price of Work <br /> �ETn;/ �%E�C- <br /> Pr�posed Use of Bullding Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: �1.�//j/1,/� OY f���� M�T�KS A�1J /✓A/k—/nJ �UG��iQ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ^ <br /> i� <br /> �' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat 1 have read and examined this application and know the same to 6e tr�e and <br /> correct. All provisions of laws and ordinances govemmg this type ol wo�lc will be completed <br /> whether specified herein or not. Tlie granfing o(a permif does nof presume to give authority to <br /> violate or cancel tlie provisions ol nny ofher stafe orlocal law regulating construction or the <br /> perlormance o/constn�c(ion. That 1 am authorized by the owner o/fhis property to perform the <br /> work/or which application is made and 1 compty with fhe Sfate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /,i:� - ' %"�-- /U—X�1 — �z� <br /> /��B�w - -_--� Date <br /> i" <br /> � � � _ � � C� <br />