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; l �' / — �'<'�"° ` ,-� ✓ <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� � 7 � ` �; ,�'/�i���'� r��' <br />PROJECT ADDRESS <br />��/�/�' �i/r� i�,4���� G�6� �/G� ? � <br />Owner <br />�dail Address <br />l ��i i/`�os'=-��1 j d" 'S �3 <br />v>�.� <br />ciry <br />State2ip <br />Phone <br />Tenant Mail Address City � State2ip Phone <br />�.l1d� `>.. �/'v� lGr/.'�r� <br />/�G/'�-���'F_;TV<�,s�j'/�% �'_�/�C. --l��vl7L'_1.,;1—�_y'=_ f q�.�`✓j <br />Elr.ctriCal Conlractor Mail Address Ciry State/Zip Phone <br /><, � - <br />� '/j�'" � 1 ( L' ° Gii;;✓ <br />Stam ucense Numoer <br />Proposed Use af Building <br />Description of Work lo Be Done: ��' � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />c;ontract Frice ot VVoric <br />Contact Person (Plan Review) <br />L�C <br />1 herehy ceRify that I have read and examined this application and kno�r the same to be frue and <br />correct. AN prc isions ollaws and ordinances govemmg this type o( �vork :vill be completed <br />whether specdied 1�erein or rot The granting o/ a permd dces not presume to grve authonry tc <br />violate or cancel ihe provisions of any other state or lecal law regulating cons:ruction or fhe <br />performance oI construct�on. rhat I am autl�onzed by the owner ol this propeRy to peAorm the <br />work Ior �vhich ;�oliwtion is rnede and 1 comply ��vdh ,he State Convactcrs Law 18.27 RCW and <br />296.200 WAC. <br />! ..� ,�- i�, �, / <br />Si nawre � Date <br />:� <br />FEE <br />i? <br />� (, <br />� � �� � � � r� <br />