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� ' <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERCTT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> �1.��l,S��OICI�IPW A'. <br /> PROJECT ADDRESS <br /> �prr�—k. Sp 1420, AEAst MA��nt Vlaa�r Ev�tr[fl N1q�9fr2o! l4X)�1-�1 � <br /> Ovmer State/Zip Phone <br /> `R�� <br /> Te ant MailAddress City Slale2ip Phone <br /> r�,lYdr�h ��l!Yrh� 8115 �ro��t�l�Ji�t Iol 6vt�!Wa9�203 �yL ;yf�- <br /> GEI'eClriC CONraCtof MailAdtlress � Ciry Slale2ip Phone <br /> ►sV�¢�,SL 11 L�2 �901 Oo <br /> � Conlract Price of Work <br /> State License Number <br /> ��� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description o(Wark to Be Done: Ul�l l Vn � �`�� �^�"•^"—` ��}'�• — " <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. 35, bO <br /> CITY OF EVERL•TT LOCAL SALES TAX CODE IS 5105 <br /> I hereby certify fhat I have road and eaamined fhis appfication and know U�o samo(o bo frue and <br /> cortect. All provisions o/laws and ardinancos governmg fhis type ol wo�k will be completed <br /> �vhefher specficd herein or noL 7he granfing o!a pormd does not resume to give aufhonty to <br /> violato or cancel fhe provisions of any olher sfato orlocal la�v reguPfing consfn�ction or the � <br /> perfoimance o/consfrucfwn. That 1 am aufhonzed Gy fhe o�vner o/fhis property fo pedorm fhe <br /> �vork lor�vhich applicafion is made and I comply with fhe Sfalo Confra�rors La�v 1H.27 RCW and � <br /> 296200 WAC. <br /> �41' q . ,�¢�I � 1� <br /> Si alure D lo � ( l� <br /> V <br />