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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �-IOz.� ��'�c��-�--, ��� . <br /> PROJECTADDRESS <br /> � � ' � I��" <br /> ��4" 1_ Lt l�l �CJ� ��Z��� 5 I � �t� <br /> Owner ldail Address City State/Zip Phone <br /> Tenanl A1ail Address Ci�y Stale2ip Phone <br /> � ._� I ' <br /> � ' .__.�'7 (� � �I�� <br /> YV�c.��v�-l'� r��-�� �c. Cu .��c,. �y.-'�� �% <br /> Eledrical Contraclor Maii Address City Sta�e2ip Fhone <br /> � C,�'I 1- I��VJI�S iV;5 <br /> Slate Licenso Number Contracf Price of Wod: <br /> Proposed Use oi Building Conlact Pcrson (Plan Review) <br /> Description of Work to Bo Dono: \`�LIJ\�(Q� �..�5���\�C J ` 1\ � 1S V�J � <br /> �.�� \V� ���Slw �UC� a����l e.��c-�cl �.e_,v�V� C�.. <br /> NOTE WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> �E IN RACEWAYS, h1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hero6y certily thaf 1 f�a�e read and examined fhis application and kno�v fhe same fo be tnie and ��� �U � ' C� � <br /> corrocL All provisions ollaws and ordinancos go��ernmc�fhis typn ol�sork nill bo compleled <br /> �rhether spen6ed herein or not The c�rantin�ol a pernut does not �resuma(o give aufhonty to <br /> violate or car,cel the provisions o/any olher sfate or locnl la�r regulnting cortsfruc6on or Iho <br /> perfomtance ol cons(�ucfion. Thnt I am nufhonzed b}�the owner o/fhis propeRy fo peAorm fho <br /> �vo�k lor which applicafion is made and 1 comply u�ifh the Stafe Centracfors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> % � /k�� l � � I ��C,, <br /> " � i�na�ur�-� Dat <br />