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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �-��� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org C��/'-l��-� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _)�� � �(�(til-I/1�.�� '\G i I_���i��� `/V !i `���(� ) <br /> PROJECT ADDRESS <br /> i .�'=J <br /> L�li��r� � � 'i � r���'u � � � �o� �,a� r-i�,�fiw�Pr� �v l,v/� ����o� 3;y�.��, l <br /> Owner �� Mall Address City Stale/Zip Phone <br /> Tenanl Mail Address City Slale/Zip Phone <br /> ��1.' 1"lE.l'� �1t,1,V1/l Ai <br /> EICCIriCal ConlfaClor Mail Address City Slale/Zip Phone � <br /> State License Number ConUacl Price of Work � <br /> Proposed Use of Buildinc� Contact Person (Plan Review) <br /> Descriplion of Work lo Oo Done: 1�.�� r�� '�Cl-r ��.C�l.l �l-LI'�'1��7 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO rEE <br /> BE IN RACEWAYS, MC OR AC CA[3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby certily fhat 16ave read and exarnined fhis apWlication and know fhe sarne to be true and L--��O� � �� I <br /> correcL All provisions ollaws and ord'mances govemm�this type ol work will bo completed <br /> whefher apeci�ed herern or not Tho granting ol a permd does not presurne to give aufhonty fo <br /> violafe or cance!the provisions o!any other state or locol law regulating conshuctwn or tho <br /> performance ol conslrucfion. That f am autho�ized by the owner o/this property to perfomi the <br /> work lor which application is rnode and I compty with fhe Sfate Contracfors Law 18.27 RCW and <br /> 29G.200 VVAC. <br /> .� <br /> /� � q ,f .; <br /> `�� '', I71 �� il �� %'��/ �Nl., � �l ' �;l _ /J �! <br /> ' SignaWre Date <br />