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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 ACCEPTED FROM 8 AM TO 4 PM <br /> 531 t�e��e.5 �J�� �e <br /> PROJECT ADDRESS <br /> ;1...�.�cs.�1.5e,� 53� t���Cs�c-. �.��r� �.9.� 98a��, �t�s-4a�-aoc�� <br /> Owner Mail Addmss City Stale/Zip Phone <br /> Tenanl A1ail Address City Stale2ip Phone <br /> �C �I�.i�. �35ot a��� �t �.k 5�k.s�.�5 v9� R8�58 ya5 5� oa8� <br /> Eleclrical Conlraclor Mail Address City State2ip Phone <br /> 1 C.E t.��, �\� C. <br /> Stale License Number Conlract Price of Work <br /> 5� ��1 1-�.� . dn..�� �-5�� <br /> Proposed U�e of Building —r—� Contact Person (Plan Review) <br /> . <br /> Description o(Work to Be,pone: � <br /> \ <br /> 'G'C� \ � <br /> n�,� � .,. �..�.� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ��� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 havc read and examined this application and kno�v the same to be true and <br /> correcL Al/pwvisions olla�vs anA ordinances govemmg fhis type o/work will be cornpleted <br /> u�hether speafied herein or neL The c�rantinc�ol a perrnd does nof resume fo give authonty fo <br /> violafe or cancel the provisions ol an}�other slafe or local law reguPting construchon or the <br /> peilormance ol consfrucfion. That 1 am authorized by fhe ownerol this property to perfo�m the <br /> �vork!or�vhich applicafion is made and 1 coi fh Ihe State Contracfors Law 18.27 RCW and <br /> 296.20 AC. <br /> - �� � ��7-9.3 <br /> Signa ire Date <br />