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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 425-257-8657-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �a �aa_l� <br /> E nla� i3`� <br /> 7So cK'ou..� �r.'« <br /> PROJECT ADDRESS <br /> � �,� � '7,S_ c�'<�U� oQ �',i�� r-✓g 9�.2a-� �i<s-6o9-S .� <br /> /�4�4 ' c ..r S o•�. �— <br /> Owner Mall Address City �tate/Zip Phone <br /> Tenanl Mail Add ss Cily Slate/7Jp Phone <br /> �OY��S-J-- 'EIeC.-fY'1 � <br /> � �,. , ,s .�or �.� l�� s�'Zsi y�sz�s- <br /> rV U Jf �tiJ <br /> EleclricalConlraclor MailAddress Ciry Slate/Zip Phone <br /> i, nc <br /> /'o�{1ee L 9rf/ O� yw <br /> State License Number Conlracl Prfce of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriptfon of Work to Be Done: �`+�c T � Sv^+P pv^'�C� i� C�wL <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE OO <br /> BE IN R,4CEWAYS, MC OR AC CABLE. Fj1 <br /> ��v <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I lieroby certi(y that I liave read and examined fhis application and know fhe same to 6e tn�e and i: I � �i7 ` '?f. a <br /> correct. All provlsions of laws and ordinances goveming Uiis type of work will be completed G L 1 <br /> whether specified herein or noL The gmnting o/a pormd does not presume fo give authonty to <br /> violate orcancel the provisions olany otlier state orlocallaw regulating construction orthe <br /> per(ormance of construction. That 1 am aufhorized by the owner of tliis�roperty to peAorm the <br /> work/or which application is rnade and 1 comply with the State Contracfors Law 18.27 RCW end <br /> 296.200 WAC. <br /> ��� ��3/i/ <br /> Signature ate <br />