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-� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 Q - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , � �� � ��;ti� �,-. E � ��� � �� � � <br /> PROJECTADDRESS -1=c /� <br /> ( US 1�. <br /> /� h'II�C' f� /-�,v��%�i� � <br /> Owner � Mail Address City State/Zip Phone <br /> � <br /> Tenant Mail Address City State�Zip Phone <br /> ,!�1�� G��nc�'��F� , �?�:i �:�v,�, �3 �,vv ��'v, cu� 9�2v3 � S�s-3���i <br /> Eleclrical Conlracto Mail Address Cily State/Zip Phone <br /> � / �� �_� <br /> ��� � CVV� � f�17 �lV � �i �. ��� <br /> Slate License Number Contract Price of Work <br /> S'- / - i� <br /> Proposed Use o(Building Conlact Person (Plan Review) <br /> Description of Work lo Be Done: C_ � � r�- (.r= �` v'T (�� L O -��tiS L Q ,)��<?/L-�f'( TU _ <br /> � 'Y���-� ii G'lJ— /�i <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 /> 1 hereby certi/y fhat I have read and exarnined fhis application and know the same fo 6e tnie and �OIPI:l -O?> <br /> conect. All provisions of la�vs and ordinances govemmg fhis type o/work will be completed � <br /> whe(her speaGeA herein orr:ot Thc grantinc�o/a pernut does nof iesume to give aufhonty fo <br /> violate or cancel the provisions oI any other sfate or local law reguPting construction or the <br /> per/ormancc ol consliuclion. Thaf 1 am authonmd 6y fhe owner o/Ihis property fo pedorm fhe <br /> wo�k/or�vhich applicafion is made and 1 cornply wifh the Sfate Conlractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> � <br /> (: � J;;.Lc��:;�� I- `�-b G <br /> SignaWre ���e <br />