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;� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> ='25-257-8810 - FAX 425-257-8857 —www.everettwa.org � <br /> �31 .,0 <br /> APPL.ICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> �22 y' G'�-(.c ��S -` <br /> PROJECT ADDRESS <br /> , ���-gc� — <br /> /�► ✓2on,' �'l�f � ��J � �.�,, n)� �voZ � Yz�L,Ne ��l�ou�. w� �sos�z <br /> Owner hlai iress Ciry Stale2ip Phone <br /> Tenant F.tail Address Ciry SWIelZip Phone <br /> EleGriCal ConlfaClUr Mail Address Cily Slale/Zip Phone <br /> Slate License Number Contracl Price of Work <br /> Proposed Usc o(Ouilding Conlacl Person (Plan Review) <br /> ,, il L'`G."f12�G/�L <br /> n ��' za�fl <br /> Description of Work to Be Dona // Q��{ S y.L✓!!_� o �t'}�/- <br /> l� <br /> NOTE: WIRiNG IN NON-DWELLINGS IS RECIUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SAI.ES TAX CODE IS 3105 <br /> I hmeby certi/y thaf 1 have read and exarnined Ihis applicafior�and know fhe same fo be 6ue and <br /> couecl. All provisiorts o(laws and ordinances�oveming this t}�pe ol�vork�vill be completed <br /> whether speci6ed hcrein or not. The granting o/a pemuf does not resurne to qive authoriry lo <br /> violate or cancel lhe pruvisions olany other sfate or localla�v�ec�uPting constriiction or fhe �L���i� — ��'�� <br /> tvork lor�vhich ac�rl c�afior��'s n a�de and�l eono�zedf�1�'��e Sfafe ContractorsPLaiv 18.27 RCiW and <br /> 296. 00 WAC. PP PY <br /> ��-- �1� � '� � �/3� o � <br /> Si�nalure te <br />