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� <br /> : <br /> ELECTRICA�L PERMIT APPLICATION <br /> CITY OF EVERET'f PERMIT SERVI�ES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> =' v r� Z M F�-�i�.� �v� '�C <br /> PROJECT ADDRESS <br /> J C> �1 � 1 �i� f/ (,�J (`01�1 -3- <br /> Owner Mail Address Cily SWIe/Zip Phone <br /> Tenanl Mail Address City Stale2ip Phone <br /> �l� � �'� ��1 ' y� �LLL� ��� �_ Q � /,f V L <br /> EleCtrical Con(ractOr ' Mail Atldress City StatelZip Phone <br /> /� I C (_,�A 1 T �-G � S�J � <br /> State license Number Contract Price of Work <br /> SF� <br /> Propos^d Use of Duilding Conlacl Person (P12n Review) <br /> Desr,ription of Work ta Be Done: ��i f= �U —� �" �� �U 0 / ) � P� <br /> NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO FEE <br /> BE W RACEWAYS, MC OR AC CABL[. �� <br /> SS — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby cerU/y fhal I have read and exarnined fhis application and know fhe same fo be frve and <br /> comecf. All previsiuns ollaws and orAinances 9overning this type o!work will be completed <br /> whefhrr s�.ecilieAherein or noL The granfing o(a permd does not presmne to give aulhonty fo <br /> violate or cancel Ihe p�ovisions ol any ofhe�sfafe or local law regula6ng construction or the <br /> pe�fomiance o�consfruclion. Thaf 1 am aidhorized by fhe owner o/fhis property fo perform(he <br /> wo�k lo�which applicafion is made and 1 corrrp/y with the Sfafe Confractors Law 18.27 RCW and <br /> 29&200 WAC. <br /> ,%�;,�_��� (� -/5-�� �., � <br /> ��� i �aWre� Date <br /> � E�C�c�.,- c0� <br />