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t <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT R�ERMIT 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 /> ` t- I��2 �� � F �� �� � �\ L �'�. c �� � ��� � C�� ��� �j <br /> PROJECT ADDRESS <br /> ��-fi 1�;�3�5� -`6k1�', <br /> , �c — <br /> -� � �'����� 1-h �-\= 7��'Z �;�t �> `= 'L�� � �; � h �.��� �-► �2�3 <br /> OWn�� Mail Address Cdy State2ip Phone <br /> -' -�, <br /> r � r. . r �1 � . �� ' � <br /> Tenanl <br /> Mail Address y City StatelZip Phone <br /> � <br /> , . V L .�1. 11 `"� - � <br /> Slate/Zi Phone <br /> �Eleclricai Conlraclor �� Mail Address City P <br /> S�te icense Number Contrect Price of Work <br /> �� �� ���1 � �^ �� � ` Contact Person (Plan Reviewj <br /> Proposed Use af8uidi�g <br /> i <br /> Descriplion oF Work to 6e Done: � � A _'� f � � �' � � � �� �` � ��� � �'� � � � `�� ��� � � <br /> . .� f� i, - D �� '�—{� C` � / , <br /> NOTE: WIRifJG IN 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 /> I hereby certi(y Ihat 1 have read and examined fhis application and know the same to be frue and <br /> correct. /�11 provisions o(laws and ordinances govere:ag this type ol work wiil 6e completed <br /> whefher specilieU herem or nuL The granting of a pern.d does nof presume to give authonty to <br /> violafe or cancel the provisions o/any o0�er state or loco�law regulabng construction or fhe <br /> performance oI consfruction. That 1 am authonzed by fhe owner of this property to perform the <br /> work(or which apphcafion is rnade and I comply with fhe Stafe Contracfors Law 18.27 RC W and <br /> 296.200 WA -- . ,,I <br /> ����n\� ;�J i�� v n v — � D te � / 1�� <br /> -- � J <br /> 5 nature (,� <br /> �1 �� <br /> V <br />