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� <br /> � _ <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 /��7 �b <br /> �/0/� -0�/� <br /> 1��� C 111ccT,�i �nr. VI �� ) 1�r�u� , <br /> PROJECT ADDRESS <br /> �1'�i ��� o ��c'S�i V�C� I ?�I� /= ��?ai i� JJ�'c��� I�, Eucre.f-( Cv`� 4g2o l <br /> Owner �- il Atldress City SlatelZip Phone <br /> cS�►1'�-� <br /> Tenant Mail Addmss Ciry StatelZip Phone <br /> `.�I11L Zn� (�C S' �c�F4l� �b�$ F�oa l�cv Pl S�. S�al-�� (a�!/�- �`���d�t ((3ov13�9-�1 <br /> Electrical Conlraclor Mail Address City SlalelZip Phone <br /> 51�� t 1�US ��c�4� (J1� $�o <br /> State License Number Contract Price of Work <br /> �'v C�S� U t'Yl� C�C <br /> Pmposed Use of Building Contact Person (Plan Review) <br /> Description of Work�o Be Dane: �-1-�;)� X.Q �e V� 7 c�' (U 1 ('P � y ��/7�2— <br /> �4�`f' <br /> S <br /> NOTE: WIRING IN NON•OWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I he�oby certify Ihaf I havo read and Qxamined this application and kno�v the same to bo(rue and C/ <br /> conecf. All provisions o/laws and ordinancos govemmg fhis type o/�vork�vill be comple(ed � �� Zl L�0 <br /> ivhofirer speciliod herein or noc The granfing ol a pemut does not prosume fo give authonty fo <br /> violafe or cancel Ihe provisions oI any ofher state or local law regula0ng consfn�cfion or fhe <br /> pedonnance o/conslrucfion. Thaf I am authonzed 6y the owner o/Ihis property to peAorm fhe <br /> �vork/or�vhich applicafion is made and 1 compfy with fho Stafe Confracrors Law 7827 RCW and <br /> 296.200 WAC. <br /> ���%%�"�G2 � a����� <br /> '] -'--SignaWre Date <br />