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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 <br /> � L-r' � — V l�.F-`� ��'�� � <br /> PROJECT ADDRESS <br /> �'�'��`,tit.1 �-���, zE��- o ��<<� k� _���� - <br /> OWnCf M11ail Address City State/Zip Phone <br /> Tenant h4ail Address Cily Stale2ip Phone <br /> �\ (�_ A _�[.C'�_�(:,�iC�lJ'�j <br /> lttj-d�l 1... ��-LL \ ���- r ��l Z� �J1Lk1t-'���' �'CLtZ ��LL ����t��1�1`�tt L'�%t'1 ( <br /> Electrical Conlractor Mail Address City S�ate/Zip Phone <br /> i�c' <br /> ����LC'G.-�7C �'�� /Jl� � `j'Z�O <br /> State License Number Contract Price of Worh <br /> � '—' <br /> , � -f _. <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ��r� '�"`' I' �lt`'4'l �,'�'"�� <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 3705 <br /> 1 hereby certily fhaf I have read and examined flris applicafion and kno�v fhe sarne to be frue and <br /> conecf. All provisions ollaws and ordinances govemma this type ol�vork�rill6e complefed <br /> whefher specdied herein or noL The grantm�ol a pernn(does nof resume to give authonty to <br /> vio/afe or cancel fhe provisions ol any ofher stafe or local law reguPting construcUon or fhe <br /> per/onnance o/conslruction. That I am aulhon�6y the o�vner ol this property to perlonn the <br /> work lor�vhich�pplict�ti0+�.is made���Om (y wlOi tlie Stafe Contractors Law 18.27 RCW and <br /> 29�.�00 WAC�� � � . <br /> -� �- ,:- __ . ._ <br /> ' � ' � '"� �\ - � `� �� L. � ( <br /> -_ �-C I '� .%--- - . <br /> ` - <br /> " ignature , —� \ Date <br /> �o�oR-�s3 <br />