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/ <br /> ELECTRICAL PERMIT APPI..iCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25?-8810 - FAX 425-257-8857—www.everettwa.org <br /> � 3 ����7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM y <br /> � � ~.�� �t .� � - <br /> PROJECT ADDRESS <br /> OWner Mail Address Ciry Sta�e�Zip Phone <br /> -i�- � � � '' �'� r i � ,�'�-1 <br /> C��i�� i ,� �.�� �1 � � ' 11�=� ��_I � � i�at 'i r ��r, ���;� i � <br /> Tenant Mail Address City State2ip i��f-��,(/�,Phon�`j 1� <br /> 1 'r r <br /> , n • <br /> C� �;-i�� II :� � i II'_ %l�j'i � �i� �� ��C��i�(� 5C�'1 �i+IILI L�C.� �III� c_ <br /> Electrical Contraclo� �,� Mail Address � . � Ciry Stale2ip Phone <br /> � � �r� �_ <br /> , c_ ,:.��;�,� � <br /> ���� � � �� ,i'_ . .� ���, •�' )�1�� , —.� <br /> Stale License Number Contract F'rice of Work <br /> ���l�:�r, ;-� �;�-�,�-1;�-�r--i-��L <br /> Proposed Use of Building Coritacl Person (Plan Revie�v) <br /> Description of Work lo Be Oone: ' I I ' ' . i '�� � ' - .� ` � <br /> 1 <br /> NOTE: WIRING IY 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 /> 1 hereby certily fhat 1 have read and examined this applicafion and krow the same to be true and <br /> cortect. All provisions o(laws and ordinances governing this type o/work will be completed <br /> whether specified herein or noL The granting of a permd does not presume fo give authonty fo <br /> violafe or cancel the provisions ol any otlier state or local law regulating construcfion or the <br /> peAormance of construc6on. Thaf I am authorized by the owner ot this property to peAorm fhe <br /> work!or which application is made and 1 comply witb Ihe State Contractors Law 18.27 RCW and <br /> zss.zno wnc. <br /> ; _ <br /> � '� � <br /> ' 11 � � ---- ----� �,��,�/ <br /> Signature Date � <br /> � �l7 <br /> ,� <br /> � <br />