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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 ACr,EPTED FROM 8 AM TO 4 PM <br /> to ,� �,�..r��vr, Av� _ <br /> PROJECT ADDRESS <br /> -��.�.� `�-� S <br /> �2�_�S�-�.�A��-�2 �c�2 c,�n�v' ,� .� v wr4 `Ic�� �o� �b �:i k�. <br /> Owne� Mail Address Ciry Stale/Zip Phone <br /> ��l'`�/�'�'-� <br /> Tenant Mail Address City State/Zip Phone <br /> ���v%���� <br /> ElCctrical Cont�aclo� Mail Address City State/Zip Phone <br /> State License Number Conlract Price of Work <br /> I(Yi!1 /l`���%F�J•'�L�� _ <br /> Proposed Uso of Building Contact Person (Plan Review) <br /> Description o(Work lo Be Done: f�� "'`�=� L' � � ' ' '�� � � l " �`��� <br /> � ( ' �C��( (�� `c/�2�/�1Ftn/ f' �1V� L 1 CItTi � �ii�r:�_'SZ7-��— <br /> i <br /> NOTE: W IRING IN NON•DW ELLINGS 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 fhaf I have read and examined fhis application and know fhe sarne lo be We and <br /> conecL All provisions of laws and ordinances c�overnmg fhis type o(u�o�k�vill be wmplefed <br /> �vl�ether specified herein or noL The granling ol a permd does not resume to give authonty to <br /> violate or cancel fhe provisions o(any ofher sfafe or local law reguPfing consfruc!ion or the <br /> perlormance o/conslrucbon. That 1 am aufhorized by fhe o�vner ol Ihis property to perfonn the <br /> work lor which applicafion is made and I comply wifh Ihe Stafe Conlracto�s Law 18.27 RCW and <br /> 29&200 WAC. <br /> \ <br /> ` ����'lCv�^ �`e..,�eUa.:^�� `� �t 7�C�L <br /> Signalure Dale <br /> r ,b , / _ / � ,1 <br /> ( �r <br />