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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � _ 5� �I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-wvuw.everettwa.org �//Q S-Do�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ) 3a 3 j�'1 �I� �-f-. ����—,rc��7—�J—� �4a�or <br /> PROJECT ADDRESS / <br /> , <br /> I,P�-T �u.���. vv��}�� 13� 3 �n�e �, �,��e,r�-t U1�1 `(�;�o' �2� 31�-°IS <br /> Own � Mail Address City State2lp Phone <br /> Tenant Mail Address Cily State2ip Phone <br /> ��-���ro.� r-�ec_-��ie J��'33 `I�4l, �.ve,N� m'l.�li �� G�0{I ao6�39 �� <br /> Electrical Conlraclor Mali Address City Stale/Zip Phone <br /> �� H��► rz�o� ��s 5�. �� _ <br /> State Liconse Number Contract Price of Work <br /> �a...kt-�1�,l��m c�,r� <br /> Proposed Use of�uilding Conlact Person (Plan Review) <br /> Description of Work lo�o Dono: l�l� l � l'�^, � � � G , (/� �� <br /> ;�� � � t *�l, _o <br /> lr'-at,l�,�f�l l�}"11C.�•fnt� � J"�f O�^Z. S)1�L�-1/Pf' Gl�''cU �'�" �71'C2�-�'✓� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �S00 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � <br /> 1 hereby certi(y fhaf 1 havo read and exnmined this applicafion and know fhe same to Ge truo and � � (� ,� _ U�S <br /> correcL All prnvislons o(/mvs and ordinances�ovemmg this type of work n•ill be cornpleted <br /> whefher speci�ed herein or not The grantin�o/a pernut does not nesumo to give authonry fo <br /> violato or cancel the provisions of nny otl�er sfafe or/ocal Inw r�gulating consfrucfion or fhe <br />� performance o(cons(rucfion. That 1 am aulhorized by tho awnero/fhis property to pedomi fhe <br />� �vork fo��vliicl�� plicnfi�de and/comply with fhe Sfote Confractors Law 18.27 RCW and <br /> 296.200 W <br /> ,!� . � 1 <br /> j, SignaWre ata <br /> �/ <br />