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=y� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �.�S� <br /> lY�'�- � fVGe<'r� n�ac.�- wv �C✓tafr� 5�r�f.' <br /> PROJECTADDRESS <br /> Ownef Mail Address Ciry StatelZip Phone <br /> T�J ivt.4X�C -�(!�'ES l`�flZ SC• E�,eefn n+ac� J.J� EvE2En. Wra /`bZ�`£� <br /> Tenant MailAddress City Slate/Zip Phone <br /> �.6PHY� c�wv,nuNt�ar�c�s 3zoT /SrA-v£ S SF,�rttaE wR /�'fr/3`/ 7�fr •zb?-Slbo <br /> ElecMcalContrador MailAddress Cily Stale2ip Phone <br /> �EPI-�YG� r�r��`GJ/- `�(�r ,� SO- vv <br /> State License Number Conireot Price of Work <br /> �Z�T���_ J�su�,..� KNo� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: i'1s�ft-�c.. �ra�c.� �,.r„a� 7.tL.�.�ln c.��r7c.f�fS <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ced!(y fhal I have read and examined this application and know the same to be Vue and <br /> correcL A.'I provisions of laws and oa�inances goveming(his type ot�vork will be completed <br /> whether speci(ied herein ornoL The granfing ol a pemnf does not presume fo give aufhority to <br /> violafe or cancel the provisions ol any other s(afe or local la�v regu/ating consWcfinn or the <br /> peAomrance olconstrucfion. Thaf I am aufhonzed by Ihe owner olthis property to pe�/omr fhe <br /> �vork lor which application is made and 1 comply wifh fhe State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> : 7,-�'._..� �� �� �.t ��-�� <br /> `__'S�aWre Datc —T <br /> E �'�c�5� i5�/ <br />