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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES a� _o� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � ` <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org � o g07-� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l'7/(c h�e�.v; F� A�U� <br /> �� <br /> PROJECT ADDRESS <br /> ,�� w, Za.l��� 171 Z F1 e�', N-f�+l� '�-ti l, i.l)� (y2 2S�i�3�V� <br /> Owner Mail Address City State2lp Phone <br /> \ - �-��f ,)lvr� �y zLfo� <br /> —��-T��' .� a <br /> Tenant Mail Address Cily State/Zip Phone <br /> �w L� �. �. .. � •� <br /> � l.l� r1 P� <br /> EleC�riCal ControClor Mail Address Clty Slale2ip Phone <br /> �i d'X� c� <br /> Stale License Number Contracl Price of Work <br /> '�,-e � A��_,1, �� � � ��rv� 71e h� <br /> P�r pos�of Buildin3 �� Conlacl Person (Plan Revfew) <br /> /7 , <br /> DescriplionolWorkto6eDone: ".� c'�..r"��� ��jS���� C:�'dhrs <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRFJ TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 ����� _ i�c,� <br /> : •' � <br /> I hereby certily that 1 have read and examined fhis application and know the seme to ba frue end <br /> correcL All provisions oflaws and o�dinances govemmg this rype oI work will be complefed <br /> whefher specified herein or not The granting o(a permrt does notp resume to give authonty to <br /> violafe or cancel fhe provisions of any ofher state or local law regulefing conshuction or fhe <br /> perfomiance o/construcfion. Thet 1 am authonzed by fhe owner o/thls property to pe�form fhe <br /> work lor which applica(ion is made anA 1 compty with fhe State Contractors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> C � <br /> ` �` �` 7/7f / c� <br /> �.SigtuWre__-'-i-.:�� " Dale <br /> i <br />