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� � <br /> . � <br /> ELECTRICAL PERMIT APPL�CATION <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 <br /> ���, � �-r ��v�rJ /'rv� <br /> PROJECT ADDRESS <br /> 5 l:�� ��.' l� �J 1 1=U�� i�vlll.�)> >_)ZS ���I 1�� )��L�,� <br /> Owner Mail Address Cily Stale2ip Phone <br /> Tenant Mail Address City Slate/Zlp Phone <br /> I�,� � � i N i y � �c..�r.�L e� � �v � <br /> Electrical Contradur Mail Address Cily SIa1elZip Phone <br /> M� l, ���; 1= ���� �; .� <br /> Stale License Number Contract Price of Work <br /> � )=1� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description o(Work lo�e Done: � - �=l'': 1� V�l)> C=v i'��1'1 �=�4)� 1)=lUj�' S r��V I L) <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ?�� �` <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily tha;1 have read and examined fhis applicafion and know the same fo be frue and <br /> conecL All provisicns ollaws and ordinances governing fhis type ol wo�k will Le cornpleled <br /> whefher spea6ed herein or noL The granfing ol a pernu(does not resume fo give aufhorily to <br /> violafe or cancel the provisions ol any other sfafe or local law reguPting consfruction or fhe <br /> perlonnance olconstrucfion. That 1 am aulhorized by tbe owne�ol this pro�;erty fo peAom�fhe <br /> work lor which application is made and 1 comply with fhe Sfafe Contracfor;Law ]9.27 RCW and <br /> 29fi200 WAC. <br /> / <br /> � ,C � � 'f .L�.- O(�, nL�� <br /> �naWre , � Dale I � 1 <br /> !� ^ J <br /> ��V i <br /> U� <br />