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l <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY OF E'JERETT 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 /> .�� �`� V � � L_ 7l� (r�- �l� V��/Cl��� �(��-� �.`7f(�fll <br /> PROJECT ADDRESS <br /> ��.i� �=.r�h���� �1 10 �'� nc S�ccc! �ve rc ti �". `�`6�0� �3(vJ�����-C,G co <br /> Ow;mr Mail Adtlmss Ciry SlatelZip Phone <br /> (V �� <br /> Tenanl M�il Address Ciry Stale/Zip Phone <br /> �4.orL�� n�, G� t�F� ;c: .�„c �''a�l�.S" /��..ro(�. �vc I� .S�.:�� 1-�- �11 Sh�lc ��n� �ti <br /> Eleclncal Conlractor Maii Address Ciry G���3 3 Slate/Zip ��2,S Phone <br /> '�h � -'^I�3 <br /> �j1-,orcc � �cS 3t'1 E `�� S oo:� <br /> State License Number Conlract Price of Work <br /> a�U �\�:� V ,-, ��- <br /> Proposed Use ol Buildin Contact Person (Plan Revie�v) <br /> Description o(Work to Be Done: 1'1 � � � �^ � � / �✓�• � h � �w�.n e�r�-� <br /> (-t �� :�L. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby ceriily Ihat 1 have read and examined Ihis applicafion and kno�v fhe sarne fo be tnie and <br /> correcL All provisions ollaws and ordinances�ovemmg this rype ol work�vill be cornplefed <br /> whefher specr4ed herein or not. The c�ranfing oI a pemuf does nof resume fo give aufhonty fo <br /> ��iolafe or cancel lhe�rovisions ol any other stafe or local law rec�uPting cons Wcfion or fhe <br /> perlormance o/consfrucfior. That 1 am au(ho�ized by the owner oRhis property to perlorm the <br /> roork lor which applicafion is made and 1 compty�vifh fhe Sfate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �'� �-'�_ `7( � � 3 � O `1 <br /> Signature Uat <br /> ��U�- 7� <br />