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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> j`�� s H��U ��f <br /> PROJECTADDRESS <br /> i �+ , <br /> ��L�� � f/�,r��� ��':.vj U� CLC � �� � X,.c'��'/ �✓2���f 6b�� � <br /> Owner �Mail Address City Slate2ip Phone <br /> I/� C� �� <br /> Tenant Mail Address Ciry State2ip Phone <br /> G S� �lr���r, c- /L•S3/ 5'OLS �j�r, �U�ti� S��„��.'co�� i.✓�l 3(G (,S1 �57'(_' <br /> Eledric3l COnt2cto� Mail Address City Slate/Zip Phone <br /> GS Q�� �L GSS � 3 ,� S�O �� <br /> State License Number Contract Price ot Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescnptionofWorktoBeDone: s,C"<'��'�Cc 13.,;�n/ I CC[��'�� �G•7�� C�C'�S <br /> �/ � <br /> / I�� �'�1C fr:� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIF'ED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA7(CODE IS 3105 <br /> I hereby certi/y fhal I have read and examined fhis application and know the same to be true and <br /> correcf. All provisions o/laws and ordinances govemmg fh�s fype o/work will be complefed <br /> whefher speci(ed herein or not. The granling ol a permd does not resume fo give authonty fo <br /> vio/a(eorcancelthe pmvisionso/anyofherstateoNocallawreguPhngconstrucfionorfhe <br /> peAormance o/construction. That 1 am aulhonzed by the owner of fhis property to peAorm the <br /> work lor which applicahon is made and 1 comply with the Sfafe Conlractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �+1i� � ,/ ��/i l/�/ /�- ��- n% <br /> r <br /> Stgnature Date <br /> �j�-►U- d1 � <br />