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� <br /> ELECTRICAL PERMIT APFLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-25�7-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FRL?M 8 AM TO 4 PM �� _� 5 --66 <br /> 'c (= v• , . L`�7',��� �1,� a/ <br /> PROJECT ADDRESS � <br /> Owner Mail Address Ciry State2ip Phone <br /> /,� "' L �- <br /> -� �� /-d--, � <br /> 7enanl Mail Adaress C'.� Stale2lp Phone <br /> 1 ' � -, _ <br /> , d,' �, I y ��. <br /> � 7C �'' �C <br /> �1�,�� /�i�. � i .�(U i' c, ✓ >�.:i ! / -,' ✓. � Lv b <br /> f� <br /> Eleclrical ConlfaClof Mail Address Cily Slale/Zip Phone <br /> � <br /> � l <br /> �''��;,j�,� ��, :_;;� , r =j-'S - <br /> State LicenseNumber Contrect Price o(Work <br /> '� -� <br /> �- - � ' <iv� /"1'��siS�� -�' <br /> ..�. .� � .�� '�r <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description af Work lo Be Done: � i� � �� r .� �Y'��i� S��� �� <br /> I <br /> NOTE: WIRING IN NON-D�NELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined this application and know the sarne to 6e true and <br /> I correcL All provisions of faws and ordinances governmg this type ol work will be completed <br /> whefher specilied herein or noL The grantinc�o/a perrnit does not presume to give authonty fo <br /> violafe er cancel the provisions ol any other state or local law regulafing consfruction or the <br /> � perfonnance o(construcGon. That 1 am authorized by the owner uf this property to perlorm the <br /> work for which application is made and 1 comply with the Stafe Contrac(ors Latv 18.27 RCW and <br /> i 296.200 4VAC. , <br /> i _ � <br /> � ;��� ��i. �� <br /> ' Signature ," � - • Datn <br /> � ��� �� —���� " <br /> � <br />