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r <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF ED ERTEEETPERMTT SER oICES � _ � ��� <br /> 425-257-8810 - FAX 425-267-8857 —www.everet!wa.org ��g�g�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �,/.� ��3�'i Oq�-✓ �/-�� � <br /> PROJECT ADDRESS /�pJ Z�J /d 3'�� � <br /> /�',�i,r��, Il Gr//�Gs <br /> ����. �'-'�'��'���L �.� �v ' 1`d� � !l/�¢'�° � L <br /> Ow�cr � Mail�ddrosa Ciry Slate/Zip Phone <br /> ��/�(� �ir��/Z//7 (/ �GG!/1,0� <br /> Ten:tnl h7ail AdCress Cdy Stale/Zip Phone <br /> ����-�'�/� <br /> EleC�riCal Conlraclof Mail Addiess Cily SlatelZip Phone <br /> State License Number Contracl Price o(Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> 1��•���l�—� ���/i� r/f� <br /> Description ol Work lo f�o Done: .�� <br /> NOT[: WIRING IN NON-DWELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CF�BLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��GLU-�,�� <br /> 1 hereby certi/y that I have read and exemined this application and know fh� eme to be true and v <br /> D <br /> cormcL All pruvisions o!la�ss and ordinnnces govertung fhis type ol work will be comP�eteJ <br /> whefher specfRed herrin or noL The c�ranfing o!n pernuf does nof presume fo gire autho�ity fo <br /> ��iolalo or canct�l the �rovisiens ol any ofher sf�ate or local la�s re�uletmg construcUon or�he <br /> perfonnar,ace bI cons�ruc(ion. Thaf I am authonzed b)'fhe o�+'ner ol th�s propeAy to perlonn the <br /> �vork foUvhlc����pP��cafion is rn�de and 1 cornply n�ith fhe Sfafe ContraUors Law 1d.27 RCL4 and <br /> 296200�AC. <br /> �— � <br /> � C: G' <br /> / , ,� f�,-��� G o � � , <br /> igna re Uale <br />