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i � <br /> '1 i. <br /> ELECTRICAL PERMIT APPLICATI4N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, �NA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —vnvw.everettwa.org <br /> APPLICATIONS AR[ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �, � U � �iV�V/�t,WY� tr�� <br /> PROJECT ADDRESS <br /> � � <br /> � la('l[n Q��Zlar"'h�it�' (✓?o (� Y�v=nc1. �:� 1aIYh�J.,1� �=f- , �i 1��7 — <br /> Ownef Mail. .ddress City State;Zip Phone <br /> S-��a�b�c�-� h"boZ F..I�Y��ru�tv�-:y (��.rz}-4- u�R- �1 �>Z� `'I <br /> Tenant Mail Address Cily State/Zip Phone <br /> �111 �L� YV4(1�-�G1��� �Z� I ��I'�f'� \�• K�'�`�� �/� I G � �� � <br /> ElectfiCal ContfaCtor ldail Address City StatelZip Phone <br /> ' ���/L'�l{=�.��'J °�� Z ��� . <br /> C" <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Dane: �I�(�t�f I� �� � ���' � � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIkED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRi�y that 1 have read and examined this application and Rno�v the same to be true and <br /> correct All provisions o(la�vs and ordinances governing this type of work�vill be completed <br /> whether specdied herein or noL The granting of a permd does nut presume fo give authority to <br /> violate or cancel the provisions of any other state or/ocal la�v regulafing construction or fhe <br /> perlcrmance ofr,onstruchon. That I arn authonzed.by the o�vner of this property to peAorm the <br /> �a�ork(or which application is mado and I comply�vdh Ihe Stafe Contractors Law 1827 RCW aM <br /> 296.200 VVAC. <br /> n I�I^� iu � l� D <br /> i3 iu e Dale <br /> �f b(o- l�Co <br /> I <br />