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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 -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> .2���5 y� �eG, -�-F ��.e <br /> PROJECT ADDRESS <br /> 2v I 3�'� f Itw Yf �vc �v«{-r-f (�l�r ��zr ( <br /> Ow�.er Mail Address City State/Zip Phone <br /> ���� s :4 [l� � / yq <br /> -,� � c > - ��«l .Zo /3 � �l�wrf+�"� �ve�e-ff ff /XX7�' �1zs2srA�3l/ <br /> Tenan' Mail Address Cily Stale'Zip Phone <br /> ��a�r C��c-f:�f7�c y�'9 3 �,(��5f S l,/�E�� ( Muk.lYco . �f�����5 — <br /> Ele t Cal Conlractof Matl Address City State@p Phone <br /> � `f1 S-y'Si-'ySY� <br /> ��J L �� � ��% �Z C�tract Price Work <br /> State License Number <br /> �J i l-f...,. N C\'�n,i i C/I 7 <br /> Proposed Use o(Building Contact Perso� (Plan Review) <br /> ,� ��Q��� � �/ � <br /> Descriptiono(WorktoBeDone: �Qrl �' C�+f l��LiC"f�r+c �UG �' p� / }" 'S �v`'� e <br /> �c ,2C7C"�� 1,2 a�.?9� V ? (!l <br /> NOTE: WIRING IN NON-DbVELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify fhaf I have read and examined fliis application and know the same to be true and <br /> ;orrecL All prowsions o/la�vs and ordinances governmg fhis typc ol work will be completed <br /> whefher specified herein or noL The�ranling ol a pemut does not presume to give authonry to <br /> violate or cancel the prowsions o/any other state or local law regulafing consfruclion or the <br /> p�Aormance o/conslruc(ion. That I am aufhorized by fhe owner o(fhis property to perlomi the <br /> work lor�vhich applicafion is made and 1 comply wifh fhe State Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �,%�� <br /> r���,,��-- �i���s <br /> Signa ure Date <br /> � <br /> �0 5bS-/C��' <br />