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e <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 � a ` 7_D (7 <br /> � JU, T�� �� � (G �� � � <br /> ���UD /��i��'i� <br /> PROJECT ADDRESS <br /> �IA,�i,i �a�r'k'sv�✓ ' 1 � �y7�� <br /> Owner Mail Address � City Stale/Zip Phone <br /> � t <br /> T eM A1ai1 Address Cily Slale/Zip Phone <br /> ��5���;<<�;�M no��� ���� � -�-;;� ���. ����3 3l��1-3by�I <br /> Electrical Contraclor Mail Address Cily State/Zip Phone <br /> ��f« ��7Ur�L <br /> State License Number Contracl Price o(Work <br /> C^�?/`l�f��-?(�'/j��%'�� �[�-owf <br /> Proposed Use df Buildin,�J Contacl Person (Plan Review) <br /> Description o(Work�o Oc Done: ��(,(� ��[)I���(- Ll�(� f � ����� ��a�� ¢; <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> f3E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceriily fhat 1 have read and examined this applicafion and know the same to be true and <br /> correct. Al/pro�dsions o/laws and ordinances goveming this type ol n•ork will be completed � 0�lZ—��j`'f <br /> whether speciLed herein or not Tho granting ol a pemuf does nof resume to give aufhonry fo <br /> vio/afe or cance!the�rovisions ol any other state or local law reguPling constructwn or the <br /> perforrnance o/construction. That 1 am a�rthonzed by fhe owner o(this property to pedorm O�e <br /> �vork lor which application is made and 1 comply with fhe Sfate Contractors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> Signatuie Date <br />