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f <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT S�RVICES <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 /> " : � , .- y� <br /> ,>� , � f- —�'•-,�<<a r., /Y L lC� <br /> 2- � <br /> PROJECT ADDRESS <br /> �� ' •� �, . � . <br /> � _� � F� ,'` J � '(- �'li,r„6.� �'i ilr,' (--L%;�c'ri%� G✓;"; <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenanl Idail Address Cily State/Zip Phone <br /> �� -7 <br /> `.�i�,�,�(/.�i2c:�i��.�.�.,%" %�� /�v'✓�V I�;��R .�i� �� �v S�v'1.,A.W�' �(ii� '�G�.k:�J N�'��-J'�F�-i �r� / <br /> EleClrical ConlraClOr Mail Address City Slate2ip Phone <br /> i<S'�4�u�. �F �y��i � � �-Ec��. ,��.. <br /> Slale License Number Contract Price of Work <br /> `�-<__S/.°J��,t-c - <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriptionof WorktoBeDona �;t.; %i� �( ii;t'c � � �.-; / ,n-. ��'� �-'� ,' <br /> � <br /> _�/lx:C- ie-�.Ll�la`'+.�r"'�-' .Tf7 .:.a��l %� i�/`-�(� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhal 1 have read and examined this applica(ion nnd know the same fo be frue and <br /> correct. All piovisions olla�vs and ordinances goveming this type ol work will be completed <br /> irhether specdied herein or not. The granfing of a pernut does not resume to give aulhonty ro <br /> violate or cancel fhe provisions o(an}�other sfafe or local faw reguPting wnstruction or the <br /> pedonnance o/construcfion. That 1 arn aufhonzed by Ihe avner ol fhis property to pe�fomi fhe <br /> work lor which application is made and I compty�vith the Sfate Contractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> 7 <br /> •��,_ /�i`�+-=-'� �'!a--� �> ! <br /> � SignaWrez ` D te <br /> ��(�� � <br /> L�/(�' ���� <br />