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-� <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 j( � a —O� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C—O 7I� �-d ZZ <br /> ; I C 32 - �� < � � ,. < < .� �v .� � C <br /> PROJECT ADDRESS <br /> rl CL I ' . � . <br /> Owner ail Address City State2ip Phone <br /> � I C ►� � I �, �-�,� n � � c 3 z � ��� „r � � �� � �-� � ��--� ��t � <br /> Tenant Mai Address Ciry �2ip Phone <br /> � D �� S � IY . 14Z3C- �U� �� sf �„�, � �(i r � �v r S � � 11/,. � �� z s <br /> Electrical Conlractor Mail Address Ciry State2ip Phone <br /> L. vI� S � ] K � z � � -, �J � S- a ._. <br /> Slate License Number (�L� Contract Price of Work <br /> , f������ /a r � � � �, <br /> l�i � � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description af Work to Be Done: �1/ ` t i9 '•-1 / I 7 � S � �t�t � � ' � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce�fily that 1 have read and examined this application and know Ihe same to be true and <br /> con-ecf. A/l provisions of laws and crdinances governing fhis type o(work will be completed L d�'�—�2Z- <br /> whelher specified herein or noL The grantin�o(a permd does not presume to give authonty to <br /> viclate or cancel Ihe provrsions of any other sfate or local law regulating constructwn or the <br /> performance o/cons(ruchon. That 1 am authorized by ihe owner o(fhis property to peAorm the <br /> work lor which ap'plication is rna e and I comply wifh fhe State Contracfors Law 18.27 RC W and <br /> 256200 WAC.' <br /> i � � ��� Z �� 1; � �i � <br /> � � <br /> _�g ture Date <br /> I <br /> i <br />