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I <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 <br /> ,��n/-�— "� . ��ciTN� `C��ZCC ( � �nJ C�'�'�'?1J� <br /> PROJECT AD�ES� <br /> � r `' �_ � � �i��l I,�f� `=(kZ�1 �zS 3�`( 706� <br /> wner Mail Address City Stat=_2ip Phone <br /> Tenant Mail Address City Slate2ip Phone <br /> Electrical Gonlrador h1ail Address Ciry Stale�Zip Fhone .. <br /> Statc License Number Conlracl Price of Work <br /> Proposed Use o(�uilding Contact Person (Plan Review) <br /> N� �/ <br /> Desr,ription of Work lo Be Done: _ l C�-1 \/� �-(f.� �t2,v�C1.. '�LL-- <br /> C 1�'�-(;w. TL�)O ( 1�U��_ U '�Ri="c ZITCo �.� <br /> v <br /> =,�.�c�r. l::_ �aQrcti�-�'l� a--,,.� R�_�ralc� 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 /> I hereby certily fhat 1 have read and examined this applicalion and know fhe sarne fo be fiue and <br /> conPcf. All provisions o/laws and ordinances govemina this t}-pr, oI wurk wi116e completed E O'IU�e� 1�� <br /> whether specdied herein or noL The granfing oI a pennd does nul presume to give authonty fo <br /> violale or cancel the provisions ol any other state orlocal la�v regu/ating consfn�c6on or the <br /> perfonnance o/construcbon. Thaf I am aufhorized by the owner o/fhrs propeity fo perform the <br /> �vork Ior�vhich applicafion is made and I comply n�ith the State C�n6actors Law 18.27 RCW and <br /> 296.2 O WAC. <br /> �'— � ��-c ��� a � <br /> , <br /> � Signalure Date <br /> 1 <br />