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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 G— I�J—D g <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �D��,,,_v�7 <br /> i <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 1� �,��v �� � <br /> PROJECT ADDRESS <br /> Ow�� lai�d�ss� ���� ����ivy��� Phone <br /> � �J✓✓v�v� 2o L �( ��ew � � ��Q-.�v' (,v�- 9X�?�l <br /> Ten2nl A7ail Address Cily Slate/Zip //Lr Phone <br /> Y 3S�-vy�U <br /> t� � <br /> Electrical Contraclor M11ail Address Cily Stale�Zip Phone <br /> � <br /> Stale License Number Contract ice f ork <br /> j�,�,s..�� � �6�.�<< <br /> Proposed Use ol Buildin� Contact Person (Plan Review) <br /> Description o(Work lo Be one: �V'� � � ��� �^'� �'1/� � � <br /> `�'' �c�/1 �9�,J•ver�,� �� �`t' l/1��J�� l�g��—�,� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herehy ccrtil}�thaf 1 have read and examined fhis applicafion and know fhe same to be true and <br /> conece All provisions ollaws�nd ordinnnces governmc�this type ol work wi116e complefed � (J�U�_/�, —j <br /> whe(hcr speciGed herein or noL T6e granfing o/a pennit Aoos not prvsume to give aufhonty to l/CJ � <br /> violate or cancel the �iovisions o(any other sfafe orlocalla�r regulnting consfruction orfhe <br /> peifonnance o/cons�n�cfion. That I am aufho�ized by Ihe owner o/this property to peAorm tbe <br /> work lor�vhich application is maAe and I comply�vilb the Stnte Contraclors Law 18.27 RCW and <br /> 29&200 tNA <br /> / <br /> ,:..-, ' d� <br /> " � Si�mluro � aIe <br />