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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �'YO��,t�i/���� ��C"�../ /.7/�4 � � <br /> PROJECT ADDRESS <br /> ��s= G-s<v - �'.�-�.� <br /> �.�.�/�'i� ✓� /" J�ib /�/ok'��ousd� �s'2 �ir� �oo -�A.� ��E��—�� —( a— '.SI/.�/ <br /> Ownef Mail Address City Stale/ iZ'p Phone <br /> Tenanl Mail Address City State2ip � Phone <br /> � ���•7�.2 9iG�. <br /> �' .�tir ' �� ;t ��,� i�3vJ'.�•=`'/1���� ���.��� ���� y���.�� <br /> lecirical Conlrac r Mail Address Cily State/Zip Phone <br /> � y 1 po <br /> ��C4K!-i✓f_=�[)'�� � / � 7ln - <br /> Stale License Number Contiact Price oi Work <br /> �t� .. f/.r.�i� �nf' �17 �P,C� t ���_, _ <br /> Proposed Use o(Building Contact Person (Plan Revie <br /> Descriplion o(Work lo Be Done: /�i Q�' �f'/�) /tQ/ ����.` <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 /> 1 hereby certi/y thaf 1 have read and examined Ihis applicalion and know the same to 6e frue and <br /> correcL All provisions o/laws and ordinances goveming fhis type o/work will be completed <br /> whefher spea(ied herein or noL The granting ol a pernut does not resume fo give aathonty fo <br /> violate or ca�cel ihe provisions o/any other stafe a local law reguPtin,q construction or the <br /> perfonnance o/constrocfion. That I arn authonzed by fhe owner o/this property to peAom�the <br /> �vork/or�vhich applicalion is made and 1 cornply wifh fhe Stafe Contractors Law 18.27 RCW and <br /> 296200 WAC. <br /> ���� � ���"� �- ' � '� lq� <br /> ,, , -a � � <br /> „ignaWre Date �r�� <br /> � V Vl <br />