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�" � <br /> ELECTRICAL PERMIT APPLICA.TION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.erg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���/ 7i��;��iilc� f�/!. , _ <br /> PROJECT ADDRESS / <br /> �!%�R�I E 1 c-'� �j�,t-i?/�� ��G�/l /�j�.�j� . <br /> 7 /� � . //' <br /> , '�,L�L/�[�.['�/�l / �"f' !((//' ���-�� :1��7 l�iir' T ( � i J/.;1 l <br /> Owner Mail Address City StatelZip Phone <br /> Tenant Mail Address Cily State2ip �/�1���/� ���/ <br /> �, � . cQ � �_, <br /> /il—`',fi,�A';- ����•�"�%'.,. . /�/�05' �'=�/��C��O �/.�,.o.�� �,�/.9 3��v�', G� <br /> Eleclrical� Mail Address City Stale/Zip Phone <br /> / r, <br /> / �/�,�/ . / 1 ,l �.. ,�� � <br /> `!/ ��� iC � /Y�� �/��/ L/ f � <br /> State License Number Conlracl Price oi Work <br /> �l��i�%� />>����� <br /> Proposed Use o(Duilding Contact Person (Plan Review) <br /> n <br /> Desciiption o(Work to Be Oone: ' ' '� '` � _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �2 - <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceriily thaf I liave read and examined this application and know the same fo be true and <br /> correcL All provisions ollaws and ordinances govemmg this fype ol work will 6e completed <br /> whefher specified herein or noL The granting of a pernut does not presume fo give authonty to <br /> violafe�-cancelthe provisionsolanyolherstafeorlocallawregulatingconsWcfionorthe <br /> per/orrn3nce o/const�uction. Thaf 1 am authorized by the on�ner o/this property to perlonn the <br /> work lor which application is made and 1 compty wifh fhe Sfate Confractors Law 18.27 RCW and <br /> 2SG.200 vVA�. <br /> �_ � <br /> i'�� .l� �^-' �� <br /> �i ,. , o �.�'��C � <br /> / Signature Dale <br /> , I/ „�1`. ��� ' <br /> / / U <br /> V lJ <br />