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� <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.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � sol m�lv�n p,�x� (u� <br /> PROJECT ADDRESS <br /> �',S�'�C. �we\\vs <br /> Owncr Mail Address City State/Zip Phone <br /> Tenant Mail Address Ciry Slate2lp Phone <br /> fl�-'�s�� I-l�,,r, �rivat� tn� liiay �i�.s+ SE �:��, � �1�90 `�as33sla�s <br /> Electrical Contractor Mail Address Ciy State2ip Phone <br /> ar-1;s���949N�i I� k <br /> Stale License Number Conlracl Price of Work <br /> IZe.-s��� <br /> Proposed Use of 8uilding Contacl Person (Plan Review) <br /> DescriptionofWorktoOoDone: L'l��'�'(I(qL �' lo�,.i ���+n�� W�r,� ir� I�W d�A�� �j�q�kl <br /> --� ��- <br /> NOTL: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF[VERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 ha��e read and examined this application and know fhe same fo be true and <br /> conecL All provisions o!laws and ordinances governmg this type ol work will be complefed <br /> whe0ier specilied hcrein or noL The granfing of a perrnd does not presume to give authonty fo C <br /> violale or cancel the provisions of any oUier sfafe or local law regu/ating construcfion or fhe ] <br /> perfomiance ol constn�ction. Thaf 1 am aufhorizeA by Ihe owner ol fh�s property to peAorm the n G)l� _ /� / <br /> �rork loi which applicafion is made and 1 ca»oly with fhe Sfate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. ( <br /> ��y� ��,� V��."'I�.'� <br /> Signature;, Dale <br /> 'J <br />