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- i <br /> ELECTF�ICAL PERMlT APPLICATION <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 /> ��G/ �J�.��Di//C��t'�/���.�✓ /.�/�ti � <br /> � <br /> PROJECT ADDRESS <br /> `/ <br /> r ,t�,�,���oo,�>>���� �,l� /��o/- �1� '� i��>�G�. u, fc ,���� � 9f�.�� <br /> Owner Mail Address City State2ip✓�j .���G_�V���Phone <br /> '/ / <br /> Tenant Mail Address City Stale2ip Phone <br /> ) <br /> �-7 7C/% ' � /I .J �' � / ,/ _/ i <br /> —/—�/ -R�r�� :',./—/�_f'�'� /,>l`_ ��� D� 'S• " '= /�uf_' lc� . [�i>/lo.c)�i�' -� ��D� �Ta�SJI'/ol• l/G <br /> Eleclrical Contraafor Mail Address Cily Slale2ip Phone <br /> ��Il�/�N�=%�.,�� l�J3�.� � s <br /> Slale License Number Conlrac Price of Work <br /> ��P� ✓�n f ,�1c1�, <br /> Proposed Use of uilding /' Contact Person (Plan Review) <br /> Description of Work to Be Done: (i�i/f l' �'4� �j� 7� ���/ Gi' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. _ j��� <br /> <� <br /> '� � �Ulo 3. / S <br /> � � , <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ,� <br /> 1 hereby ceAily fhat 1 have read and exarnined fhis app/ica(ion and know the same to be Vue and <br /> correct. All provisions ollaws and ordinances govemmg fhis lype ol work will be complefed <br /> whefher specilied herein or noL The granting o/a pennd does not resume lo give authonty to <br /> violafe or cancel the provisions ol any other state or local law ieguPting consWcbon or the <br /> pedormance ol construction. Thaf 1 am aufhonzed by fhe owner o/fhis property to peAorm the <br /> work lor which applicafion is made and 1 cornply wifh fhe Stafe Contractors Law i8.27 RCW and <br /> 96.200 WAC. <br /> � � <br /> �"� �%a/ ,�,�, �1= ��„ : iz> - 3 � �s � <br /> ignaWre Date <br /> �� �/��� W�O <br />