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—� <br /> ELECTRICAL PERMIT APPLiCATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820' <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> _� �/ � � I' <br /> pROJ ECT ADDRESS <br /> �< <-� ��:I� I <br /> Otvnef `-0a' Address C�ty Slale/Zip Phone I <br /> Tenan� Mail Address City Slate/Zip Phone <br /> �-�r�s �(�(! 73� �v�J/ /�!�G�, S1'1�,2'd�k//�" �Zj Z <br /> , <br /> EleClrical ConlraClof Mail Addmss City Stat i �Phone <br /> (�-��., � t�3`� � ��� � � <br /> State License Number � Contract Price of Work <br /> ���D� ,� C�cr�� � /�r��}�'m� <br /> Proposed Usr.of Buil ing Contacl Person (Plan Review) <br /> Description o'Work to Be Done: !L'// _ � �� 7l — � ��� ' ' " ' <br /> i/ � <br /> NOTE: WIF�ING IN NON-DWELLINGS IS REQUIRFD TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> . I hereby cerfily fhat 1 have read and examined fhis applicafion and kno�v fhe same to Ge frue and <br /> conecL All proyi ns ollaws and ordinances govennng Ihis type o/work will be comp/efed <br /> I �•,�hether specd�ed h�rein or noL The granling ol a permd does not p�esuma fo give autliority to <br /> violate or ca fcel th pi�visions olany oth s fe or local law regulaling construction or fhe <br /> I ��eAorman .. o/con vVuction. Thaf 1 am ized by the owner o/this property to perlorm the <br /> �,rork(or w iich appl cafio is ma d ply wifh the Sfate Contractors Law 18.27 RCW and <br /> � ?9G.200 ✓AC. <br /> � �'/9-�r�'' ,� � � � <br /> i ignature Dale ; 1 <br /> ,(,,._ <br /> ;; <br />