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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g � �O—�cj <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org C 0��g�j�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,2.20� ��f �/�rQ <br /> PROJECT ADDRESS <br /> ���ii G�✓cGLs�-`! �ZOf� r�i��/H.,.r� �e�B� L,c�q l z7'3�,���7 <br /> Owner Maii Address Cily Slale/Zip Phone <br /> Tenanl Mail Addross City Stale/Zip Phone <br /> ll�c.+���1'�rns�HL,2�8s���Dfy�G'�/c%ffi��y. �"7�OOMh�3.�34�1,�1�%l�l �f�o�i �1,�,r1�,��/� <br /> Elec�rical Coniractor Atail Address Cdy �--T Statc/Zip Phone <br /> !,`�Gt/r'Ir',�/ /«��k <br /> Stato License Number Conlract Price o(Work <br /> ✓ <br /> �� - �� ✓�,�� <br /> Proposed Use o(Duildin� Contact Person (Plan Review) <br /> Doscnplian of Work lo Oe Donc: AI/P;I�f����'L Z <br /> NOTE: V�'IRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CABLE. <br /> i <br />� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce�lil}�thaf 1 har�read and exnrnined ihis applicalion nnd know fhe samo fo 6e frue and <br /> correcC All pravisions ollairs and ordinances goveminq fhis type ol work will6e complefed <br /> whether specified he�ein or noL The granting ol a pernuf does nol presume to give authonty to <br /> violato or cancel the pro��isions o(an}�other stafe or local luw regulafing construcfion or the <br /> perfomiance of cons(iuction. Thaf I am oufhonzed Ly tha ownor ol fhis property fo pe�/omi the <br /> work lor which applic��fion is mndo and 1 comply wifh fhe Sfafe Confracfors Law 18.27 RCW and /� j <br /> 296.200 N�AC. i�Q <br /> �____- �z�4y (�� �,, <br /> Si�nature Date � <br />