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s <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 /> i�oi y>�,���;�1 CJ,� Pl � /.�i�o �� <br /> PROJECT ADDRESS <br /> i � n <br /> /�, /� /(JL�Jl'/n n ,�,�:,�.y . � <br /> Owner Mail Address Cily State2ip Phone <br /> Tenanl Mail Address Cily Slale/Zip Phone <br /> � �� �r��7�5'�3�5� <br /> %���ic/r✓ic%%=/ � :�'�'oir �Cs�` ���OhJ .7�''=i'�J.NC� � /_.+�'„�ii�.Ji/s l�JI Gl,',��� � <br /> EleclriCal ContraCj r Mail Address City State/Zip Phone <br /> l _ G <br /> i������=����J� ��v �, <br /> Slale License Number Contract Price of Work <br /> l (, � <br /> � / Y /J�� l <br /> �,-..� ��...�.1 <br /> Proposed Use of'Buildinc� Conlacl Person (Plan Review) <br /> Description of Work to Bc Done: �.� �)�,^ �� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily thaf 1 Bave read and examined this applicafion and know fhe same to be true and <br /> correcf. All provis�ons ollaws and ordinances governing this type olwork will be complefed <br /> whether speafied herein or noL The granting o/a pemuf does not resume lo give authonty fo <br /> violate or cancel fhe provisions o/any other state or local law reguPting consWcfion or the <br /> perlormance o/construction. That 1 arn authonzed 6y the owner of this property to perfonn the <br /> work/or�vhich applicalion is made and I comply wifh Ihe Sfate Contractors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> .� . <br /> / <br /> ; '</ `� �--/ 3 - � (�� <br /> ignalure �ale � <br /> . <br /> C.� <br />