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r' <br /> � <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 �� o��"� <br /> j I i 7 � C"Z f 1Tti �a L d �/ <br /> PROJECT ADDRESS <br /> � � � <br /> � , 9�� ��� <br /> %�S 2 G� 1c �1 �G��s n � Lt.��Q�-� <br /> OWner Mail Addross City State/Zip Phone <br /> Tenant Mail Addross City StatelZip Phone <br /> G.� !_ S(� <,f,c« �C, o I C-�..-..n�... ��' I.�:-C �� L", "l,� 75 <br /> EleClrical Conlraclor Mail Address Cily Stale/Zip Phone <br /> LC FLSc � � � � �.� 1j�' crZ' <br /> State License Number Conlracl rice oi Work <br /> Proposed Use of Building Contact Person (Plan Review� <br /> Description of Work to 6e Done: � �"�' �� �'�--� ��� <br /> Y <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 certil}�fhaf I have read and examined fhis application and knon•the same fo be We and �Q li �� — �� ?� <br /> correct All provisions olla�vs and ordinances govenung this type ol work will6e comp/efed <br /> whether speaficd heiein or not The granfing o/a pemut does nof presume to give aufhonty to <br /> violafe or cancel fhe provisions olany ofher stafe or locallaw regulating consWcfiun or fhe <br /> perforrnance o(constniction. That 1 am authonzed by fhe o�vner o/fhis property to perform the <br /> work(or�vhich applicalion is made and 1 compty�rifh fhe Sfafe Conhacfors Law 18.27 RCW and <br /> 296.200 l4�AC. <br /> ` �3--� �� /� l <br /> / �, /� C, <br /> Signatura Dale ' <br />