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ELECTRICAL PERMIT APPLICAYION , <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l��1 ��% T���. �It ��vt L ✓r ;� I� �/��i�' ;/ <br /> PROJECT ADDRESS <br /> i:1, <br /> _� , rl� �I .��C�l /o�y�,� �I —�"•-��.. ''�VC- L i::�v f�� � �r � �'����� �c/� z�-`1L�I <br /> Owner � Mail Address Ciry State/Zif Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> [lec!rcal ConUaclor Mail Address Ciry SWte/Zip Phone <br /> Slale License Numher Conlract Price of Werk <br /> %�Jt�S< < < ����IG.� I <br /> Proposed Use of�uilding Conlact Person (Plan Reviev�) <br /> Descriplion of Work lo Be Done: /,'J ti'{i� �I �� c..'� ��'�� /� ��e��7'f'� 1 � nh�:���7�^ <br /> :� lir�v t�� � r(:�,,���_ <br /> � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FE� E — <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> f <br /> CITY OF EVERETT LOCAL SAL.ES TAX CODE IS 3105 <br /> I hmeby certil}�fhat 1 hnve read and exr+mined fhfs applicz6on and kno�v the sarne fo be frue�nd <br /> cu�racL All provisions ollu�vs and ordinances governmr�this f}�pe u/work�vill be complefed <br /> whether spec�6ed herem or noL The grantin�o/a Perrnd does nof preswne to give autho�ity fo <br /> violate or cancel fhe provisions ol any other sfate or local la�v regulating consfruction or fhe <br /> pe�fommnce ol construction. That I am authorized by Ihe owner ol fhis propeMy fo pedorrn the <br /> work lor which apU��ca(ion is made and I conipl}�wi(h flie State Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> , - i ,.—�_ ,,�, ',;- , '� i;�lc�- O�(1� <br /> ;� Signature ' Uote <br /> � <br />