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i <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.everettwa.org <br /> APPLICATIJNS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �h�0� �,.�.o..�',Pi/��.�/.�•'�,s ��G�E' _ <br /> PROJECT ADDRESS <br /> �i�Jl'�b�l ii�fl::JT/� ✓" ���"(��' 1j��HL� '[✓ rJ( / L t 7�J�.3(0 ��'h �o�Y� '/.-1 'Yr.� <br /> Owner Mail Address Cit Stale/Zip Phone <br /> Tenant Mail Address City Stale/Zip Phone <br /> `7��`-,tJN� / �'��� (O� /���J.�.�=`'A�r•� ��,�<, �����D�� �.�s �-�.�,�/�� <br /> Eleclrical Conl ctor Mail Address Ciry State2ip Phone <br /> J��C�,cJ�,JL- ! �a � � � 7� �'��. c � <br /> Slate License Number Gxlract Price of Work <br /> /) � J <br /> Propose Use of Buildu� Contact Person (Plan Review) <br /> Description of Work lo Be Done: �/.Q�. //Le � �D� �f/,/ N <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> /�3% �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceriily Ihaf 1 have read and examined this application and know the same fo be frue and <br /> conect All provisions ollaws and ordinances goveming fhis type o(work will be cornpleted <br /> whether spea(ied herein or noL The granting ol a pernuf does not presume to give aufhonty fo <br /> violafe or cancel the provisions o(any ofher stafe orlocallaw regulab:;g conslnic6on orihe <br /> pe�fom�ance o/construcfion. That 1 am authonzed by the owner o/fh,s property fo peAomi flie <br /> work 7or which application is made and 1 compty with fhe Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �• ) � � D- -b S <br /> SignaWre Date <br /> � � -d `� / � " �� <br /> �--�._ <br />