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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY G`F 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 <br /> � � � rn�n�oe a� �� <br /> PROJECT ADDRESS ' <br /> �.�1ri 5 �'IGG ?,Zo1 ►Nwhro� A, v Sve� wYe �t � zb� �zs3s3�i/6 <br /> Owner h1ail Address Ciry Stale/Zip Phone <br /> /���� <br /> Tenant Mail Address Gly State/Lp Phone <br /> Eleelrical Con�raclor Mail Adtlwss City � Sta1r.lZip Phone <br /> Slale License Number ConUacl Price of Work <br /> �`�I 4\�C L- <br /> ProposcA Usc ol8uilding Contacl Pertion (Plan Review) <br /> Descriplion of W ork to �e Donc: �� Z� A �Qf�J1�.---- <br /> � s�. �1�+�_��3�r��-I�c��c_e+Mns�� <br /> NOTE WIRIfJG IN NON-DW[ILINGS IS REQUIRFD TO f-EE <br /> BE IN RACEWnYS, MC OR AC CADL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herehy ceriily tlial I have rend ond ex.inwir,d Ihis applic�tho�• and kno�v fhr, same(o br. trur. and � � <br /> corred. 1111 provisions ol laws and ordinances 9overnniJ fhis t�pa o!�vork will be complefr.d <br /> whefher spe cilied herein or nol. Thc yranling of a pernul does nof neswne fo give aufhority lo <br /> violafe or cancel fhe provisions o!any ofher sfate or local la�v regul�fing conslrucfion ar fhe <br /> peifum�ance o(consfruc(ion. Thaf I am aufhonzed b}�(he o�vner ol lhis property fo perform fhe �� 1 <br /> work lor which applicafion is made and I�erripiy�vPh (ho Sfafe ConVacfors L;nv 10.27 HCW and / O� <br /> 29G.20U WAC. O� <br /> �( -�--_ �- � 3 � � /D <br /> — – _-Siqnahue _ — -Date <br />