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O �/ � �lZ � % <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �� _ �� _p � <br /> 3200 CEDHR STREET, EVERETT, WA 98201 ��I _�9.� <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org EO <br /> APPLICPI'IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �.�� �{'02�1-� ( )r <br /> PROJECTADDRESS <br /> 7u3- LlG 3 <br /> ��/ - ! JL.Z �.Uvz- ri. �r �.-. " 7�f �l4 �r�7 •�'� /> 7s3 <br /> ��=C1 f- C'7/G-•1 64 <br /> Owner Mail Address Ciry SlalelZip Phone <br /> Tenant Mail Atldress Cily State2ip Phone <br /> 3C.o GLY- <br /> ��� � i ,�- �� ����z �� �r�`'s�s� t�'< ���,r. x�, � � ys�q� � s��.�� <br /> EIeCIfiC21 ContfadOf Mail Address Ciry State/Zip Phone <br /> �c,��aNt�� � s-l� cz <br /> I �I� I�� ( I 1C G�L+ •rv <br /> State License Number Contract Price of Work <br /> n_�S �,,.A, � �- <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Work to Be Duie: 1"�-r�c � � �1C.,v��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby certi/y fhat 1 have read and examined fhis application and knon�fhe same ro be true and n� <br /> conect. All provisions ollaws and ordmances govemmg Ihis rype ol wo�k will be complefed ��jq,`�_U <br /> �vhether specdied herein or not The granhng o/a pemut does nat presume to�ive authonty to "v <br /> violate or cancel the provisions o�any other stafe or local law regulahng consfnic6on or the <br /> peAormance ol construchon. That 1 am aufhonzed by the owner o/thrs property to perlomi the <br /> work lor which applicafion is made and/compty wdh the State Ca�tractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � 1� <br /> ���� <br /> Signature Date <br />