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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE'rT' PERMIT SERVICES <br /> 3200 CEDAR STRE�ET, EVERETT, WA 98201 6 _ y_� <br /> 425-257-8810 - FAX 42:i-257-8857 —www.everettwa.org <br /> C O�JO Fi -�a-� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �(/6 C-'i�.,:�. � /�,•.'„ � C,.�-.-ri�` �� f �'��+ i <br /> PROJECT ADD E S <br /> /`�..H� �/ l, u.� / lf/c� �/Y•,.�, , /,,. ' /_=o�.r"� [�//� /��5i G' >' <br /> � <br /> Owner hlaii Addiess Ciry State/Zip Phone <br /> /�'� /f <br /> Tenanl �M17ai1 Address Cily Stale/Zip Phonc <br /> Jv ..i r <br /> ElecUical Contractor F.tail Address Cily StatelZip Phone <br /> Slate License Number Contract Price o(Work <br /> �.��/ f l'.�r, <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work io 0e Dune: k' ,,�.• �� r..- ��r i , o -o� � G�.�'� �oo. � <br /> NOTL": WIRING IN NOfJ-DWELLINGS IS REQUIRED 1 O FEE <br /> BE IN RACEWAYS, ��1C OR AC CADLF. <br /> CITY OF F.VERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereny certily fhaf 1 hace read and ezarnined O�is applica(ion and kno�s the same to be Irue and � � �,� � <br /> corre<f All provisions o/la�vs and crciinances qoverning fhis f}�pe o/nork will be completed ��� ��(,��( '�'� ' <br /> whefher speu/ied he�ein or noL The gran(ing o(a pemuf does no( �resume fo gire aufhonty fo <br /> vioLafe or cancel fhe provisions ol an}�ofher sfcte or loc'al law regulating construcfwn orthe <br /> peifomiance ol cvnslruction. That 1 am t�ufhorized by fhe o�rner o/fhis property fo perlonn fhe <br /> work lor which applicafion is rnade and 1 cornply with the Sfafe Contracfo�s Law 18.27 RCW and <br /> 296.200 WAC. <br /> . . / f� A... �_ �_ <br /> / �Siynature'L Dale <br />