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�i�� I�-0 <br /> ELECTRICAL PERMIT APPLICATION <br /> GTY OF EVERETT PERMIT SERVIG�S <br /> 3200 CEUHR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FP.X 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTEU FROM 8 AM TO 4 PM S - b a„�p "� <br /> �/ ' '� <br /> ;��-��-; r`11,(':�'�. 'il I( � l,l , l,l.? c.< < t . <br /> PROJECT ADDRESS <br /> OWnef MailAddress City SlatelZip Phone <br /> I � I�lcz x�_��t�> ��1����- (Yl r � � I,�u �� S�i Qn�:�:�F <br /> Tenant Mail Address City State/Zip Phone <br /> ' � � � c � I���c �l ?'� ����`� �1��- ��_ <<�r,lir�iJr�;� �Y��.�2 - <br /> ��� �� � � � � <br /> Eledrical Contractor Mail Address City State/Z�p ho � <br /> �iz5- �S� 1� <br /> I'� :��1 �11 i�i�� I �i'� " ,Z�0 .�" <br /> S�tate License Number Conlract rice of Work <br /> _y� �r � � �i< ,� I(�' ���c �-��'t'� ��'1�a�U <br /> Proposed Use of Building � Contacl Person (Plan Review) <br /> Description of Work to Be Done: ���{I1'� ` — �5�� ,� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceAily fhat I have read and examined this application and know the same lo be frue and <br /> wrrect A/l provisions o(laws and ordinances goveming this type o(work will be completed <br /> v.liether speci(ed herein or noL The granting o(a pemut does not resume to give authonty to <br /> violate orcancel Ihe provisions ol any oNiers(afe orlocal law reguPfing constnicfion or the <br /> I per(ortn.y�ce of cons(ruclion. That I am au(honzed 6y the owner o(this propeRy to peAomi(he � � <br /> work(�r which applicatiai is made and 1 comply�vith the State Contractors Law 1&.27 RCW and <br /> 296200 WAC. � /J <br /> I{ J <br /> �Y � I <br /> � GL � `J l.' <br /> ' � nature� Date <br /> � <br />