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� - <br /> ELECTRICAL PERIV�IT APRLICA�ION <br /> CITY OF EVERETT PERMIT SERVI�ES <br /> 3200 CEDAR STREET, EVERETT, Wq gg201 <br /> 425-257-8810 - FAX 425-25�-8857—www.everettwa.org <br /> APPLICATIONS !aFE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8�CREDIT CARDS ARE NOT ACCEPTED <br /> l"d�/G/� c�d�`� ��P�Co <br /> PROJECT ADDRESS <br /> ��/�r�-� ��C.i�*� `( "' �-l� <br /> Owner Mail Address City StalelZip Phone <br /> Tenant Mail Address Cily Slale/Zip Phone <br /> �f?�-?Z�' <br /> ��� � y12� 1��Y�Y�1cc11,l��pl� �r7 �( �0.� ' kcv <br /> Eleclrical Contractor Mail Address Ciry Slale/Zip Phone <br /> Slate License Number Contract Price of Work <br /> Proposed Use of Building Conlact I'erson (Plan Review) <br /> Descriplion of Work to Be Done: V /�(��}� {�� ��JLS -=� `•J�G�(O � e�4-✓�-{ � <br /> f i� � ���� 1� /mc� #n?� �l�v � ��r i� <br /> � <br /> �`�c �:�� <br /> NOTE: WIRING IN �dON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEINAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LUCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily th�t I have read and examined this application and know fhe same to be true and <br /> conect. All proi�isions o(laws and ordinances governing fhis type of work will l�e completed <br /> whefher speciled herein or not The granting o/a permif does not�resume to give authoriry to ` <br /> vio/ate or cancel the�rovisions ol any ofher state or local law regulating const�uction or fhe ��i <br /> performance oI co truc(ion. That I am aufhonzed by the owner oI fhis prope�ty to perlorm the <br /> work/or Ydch ap 6 t' � de and 1 compty with the State Contracfors Law 18.27 RCW and �, <br /> 296.2 N� � l�/� V/ ��, <br /> SgnaWre ��—� Date �� � <br /> � <br />