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3 �� <br /> ELECTRIGAL PERMIT APPLICATION <br /> C;ITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRF_ET, EVERETT, WA 987.01 /� -� � g <br /> 425-257-8810 - FAX425-257-8857 -www.eve�ettwa.org ` o8��`Oo/G <br /> APPLICATIONS ARE ACCEPTED FROM 8 Ah1 TO 4 PM <br /> � <br /> � � _ U � ��C��-/ �_� l<• �l� Rt��;% <br /> PROJECT ADDRESS <br /> ��1 <�J-c� ��%Urv'i r?f CQ �`-'Sr � �"�1��7tS UY��� �,(//1 �I��T G <br /> Ownef Mail Address City State/Zip Phone <br /> Tenant Mail Address Cily Slate/Zip Phone <br /> ��ti�-��r� �J_• rr��, c 1�� /�C�� ��2Z l���zlsUi/(r �1!]• �iaZ70 ���5��0-13-'/� <br /> Eleclrical CoNraclor Mail Address City State2ip Phone <br /> ��� L-;vc�- Q( � ��/3 <br /> Slale License Number Contract Price of Work <br /> � /` /7. <br /> Proposed Use n(9uilding Contact Person (Plan Review) <br /> �J��w <br /> Descriplion of VVork to Be Done: I�C�� � C� �- � '/ � �-�C' r'7�{t� �'/� iV�'L. ` I - ST/�]�`� _ <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIFED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i (�., <br /> 1 hereby ceRily fhat!have read and examined this application and kno�v fhe sarne to be true and ��� U � L t`-' �� <br /> correcf. All provisions ollaws and ordinances c�overmng this type o(work will be completed �!/ <br /> �vhether specdied herein ornoL The granting of a pernut does not resume(o give authonty to <br /> violate or cancel fhe provisions o/any ofher stafe or local law reguPfing construchon or fhe <br /> pedormance ol construclion. That 1 am authorized by 2he owner o(this property to pe�form the <br /> work lor which application is made and 1 comply with fhe Stafe Contraclors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> ��� � > �� <br /> �--�r;�..��,=� - �U�Z 4�ZC'c� � _ <br /> -- Signature G �ate <br /> � <br /> � . _. . -- ----- —�---- <br /> - ..,..w....,--..� <br /> ------_ _ _----- -- � <br /> .r.. <br />