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�, `�5' -�u-�'� <br /> E�.ECTRICAL PERMIT APPLICATBON <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> �l `il [..� c1/ �`�. Jl C:;�.,�i <br /> PROJECT ADDRESS <br /> % i', ,ll� - I;�. � �� ,.�� 1 i�.:� ;; �- .�; � ir M.,r( ���.. ���< ,-K ti.:4 <br /> Owner ' Mail Address City . SlatelZip Phone <br /> Tenanl Mail Address City Slate/Lip Phone <br /> �-�- ;�r , i � I. + � ,< <�l�lr_��-�� ii� .ic�' M ,�,I•.4 1 i-�,�� �,✓/� �7S'�`/ 3 <br /> Eleclrical Contraclo� Mail Address Cily Slale/Zip Phone <br /> i_ � � <br /> ��!'11� /-� S F 1 `J 7l l r- ��� � _` ;, C�;�� — <br /> State License Number Contract Price of Work <br /> P � , ���.< <,�_i _ �., ia, ..�.:.-, � ����� , s ��, � b �a� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> c, <br /> Descriplior,oF Work to Be Done: � i Je� �'�c� ( -. - �c , � r �" '�- � �`1 <br /> � <br /> r ,�� , 7 �� ., � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herehy certi/y thaf I have read and examined fhis application and know the sarce to be true and <br /> correct. A!1 provisions o(/aws and ordinances governuig tlus type o(�vork will be completed <br /> whether speafied herein or not The c�ranting ol a pernut does nol resume fo give aufho�dy to <br /> violate or cancel the�rovisions o(an}�other state or local law reguPting constn�r.fron or the <br /> perfonnance of consfructicn. That 1 arn authorized by the owner o/Ihis property to perform the <br /> work lor which application is made and I comply wifh the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> il ,i <br /> � ' ;/ <br /> �� � <br /> ��r{�. 'c�G7 ilvL�\ _ ��'��� % <br /> Signat re Dale <br /> ...i.�Jl ''S -�' i1y <br /> L._—_ – <br />