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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 G �I�j—O9 <br /> 425-257-8810 - FAX 425-257-8857 -www.everetlwa.org C �G a G�G� <br /> APPLICAtIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> —� <br /> �� � . � _ ,�- � � :� �J� �'� �� <br /> � �f �.._y�► .�i-�-- tl" ve� -� ' �' `� � <br /> PROJECT ADDRESS ' � <br /> �;:"L S <br /> , - <br /> � , /l � <br /> ![�Y! ,a,'1 li�� � rle- i�-. �j%,J !- vC:,��.=J-�i Gc;�' 1 .�.� -/_� �l<� <br /> OwnCt . Mail Address City Slale/Zip Phonc <br /> —��—f <br /> Ten�nl Mailllddress City Slalc2ip Phone <br /> ���,�� � �L.�cl�� � <br /> EIBGtriGal ConlraClof <<1ad Address Cily SIa1e/Lp Phone <br /> Stale License Number Conlract Price ol V�nrk J <br /> �� <br /> Proposed Use o(f3uilding . Conlact Pcrson (Plan Revicv+) <br /> Description o(Work to Or, Donc: _��.t'� v e}�l� � �,�_ _ <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO PLL <br /> E3E IN R/aCFWAYS, MC OR AC CADLE. I <br /> L_ <br /> CITY OF EV[RETT LOCAL SALES TAX CODE IS 9105 p'�1(� <br /> I haeby certdy fhaf I have read and exnmined fhis applica(ion and know Ihe sarne fo he Uue end � b l�V"" � � �� <br /> correc(. All provisions o(laws and ordinnnces governmy fhis lype al�vork will 6e compfefed <br /> whethcr spr.r,ificd hcrein or noL Thc yranfiny of a pennd Aoes nof �resume fo give aufhonty fn <br /> violafe or cancel lhe �rovisions o!any olh��r stale or local la�v regulating construclion or fhe <br /> performa�)�e o!cons�niclion. Thaf 1 am aufhonzed by the o�vner o/fhis property fo perform Ihc <br /> work for,tvhich applicafion i;rnade and I comply u�i(h(he Stafe Controclors Law 18.27 RCW and <br /> 296.200 N AC. <br /> : � <br /> f ,�-/��� ��11�� � �y/��-- <br /> �`��118 U(E .. � JIP / <br /> � <br />