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>, ;r> <br /> � , _ - l _�-�� — <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 -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �2 / 1'�I.s� /� <<�i/ �lv�- <br /> PROJECT ADDRESS <br /> � -��A«<i,� /� �IC'/�n�flf�i � l /_�,¢sT � <<�%/ �1�� �'l�c�'F/�T <br /> Owner Mail Address Cily SlatelZip phone <br /> /��� . ��c�^ s�as�3s� �� <br /> Tenanl A4ail Addmss Ciry Stale/Zip Phone <br /> Eleclrical Contraclor Mail Address Cily Slate2ip Phone <br /> Slale License Number Conlract Price of Work <br /> , Proposed Use of Buildin� Conlact Person (Plan Review) <br /> Descriplion of W�rk to Be Done: <br /> � / <br /> � _ ��'.J� �. C_�_ �_�4 �� l�.i ..� ,'i. ,+--L� <br /> „ <br /> l �� ,;'/'C;r /� � ( �� � �.��� ��-�-tL <br /> NO'E: 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 /> I hereby certily fhat I have read and examined fhis application and know Ihe same fo bo true and <br /> correcl. All prowsions ol laws and ordinances governmg this fype ol work will be completed <br /> whether specibed herein or noL The�ranfing o/a pennd does not presume to give aulhonty fo <br /> violafe or cancel fhe provisions o/any ofher sfafe or local law regulafing construction or fhe <br /> pmformance ol consfruction. That 1 am authonzed by fhe o�vner of Ifus property to perform the <br /> �voik lor which application is made and 1 comply wifh fhe Sta1e Contractors Law 18.27 RCIN and <br /> 29G.200 WAC. <br /> _ �"�('/ � , `����r �� ct �l� c�� �?�� <br /> — Signature Date <br /> � <br /> �`- � - � �o <br />