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. ', � ( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� a--/p <br /> 425-257-8810 - FAX 425-257-8857—v✓ww.everettwa.org L�CO���J <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ��D�� �OOL}- <br /> I�19 `�.��- (� A ,� - , <br /> PROJECT ADDRESS <br /> �t� . �c� (���g� -���a <br /> Owner Mail Address City Stale2ip Phone <br /> �P Y�fll)� � �L� � ���� ,�t� a�P l�h a� �(,I l�l QS�1 <br /> Tenant Mail Address City SWIe2ip /��� ph� <br /> ��.�'�I ,�LI '7/��� �'� �` Qg l ^ <br /> �Eleclrical Contraclor A7ai1 Address City State2lp Phone <br /> �Kl��n��JY PP �'�,�r5. 90 <br /> State License Number Contract Price of ork <br /> J�� h�1��. <br /> Proposed Use o(Building Contacl Perso ( lan Review) <br /> ��� �SL•'�i� � <br /> Descriplion of Work lo Be Done: � (�X �1 �((Uu/y=� <br /> r.. ,��. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> f hereby cedil}�thaf I have read and examined fhis application and know the same to be Irue and E�QU Y) 'C�D`� <br /> conecf. All provisions ollaws and ordinances govemmg this type o/�aork�vill6e completed <br /> whetherspeci��d herein ornot The granfing o/a pemut does not resume to give aufhonfy fo <br /> violafe or cancel the provisions o/an}�other state or locai law reguPating consWction or the <br /> per/ormance of construction. That I am authonzed b}�f1�e owner of fhis properiy to peAomi fhe <br /> work for which application is made and I compty a•ith fhe State Contractors Law 18.27 RCW and <br /> 296.200 tNAC. <br /> ---�-- �f�--/ G <br /> � � SignaWre Date <br />