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i { _ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-�57-8810 - FAX 425-257-8857 -www.everetrva.org <br /> � APPLICATIGNS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CAh�S ARE NOT ACCEPTED <br /> /,3 L� 2 LD i� (3AR� <br /> PROJECT ADDRESS <br /> �l'DVid�P1C� l/�eGfiCu I �ACi �i ��l �����-}' <br /> Owner Mail Address City Stale2ip Phone <br /> Co�a� CC��K�LIs . <br /> P�-L���, �'a�a., L <br /> Tenant Mail Address City StatelZip Phone <br /> vu���� �L�� . I 1 c�o Yl'ie���1 c�ic l��c«-r �-Vt�-�-� �l�'Z�� �z yo 0 <br /> Electncal Conlractor Mail Address Ci SWte/Zip Phone <br /> �c11 � ��L1 �11N ,A � ✓l , Zr�o �= <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Wark to Be Done: ��'e ��E 'rl`�IJ�`L �-�'�v� ��'j'��Wl S • <br /> NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat 1 have read and examined Ihis application and know the same to be frue and <br /> correct. All provisions ollaws and ordinances goveming fhis type ol work will 6e completed <br /> whether specified herein or not. The granfing o/a pemut does not presume to give aufhority to <br /> violate or cancel the provisions ol any olher sta(o or focal law regulating construcfion or fhe <br /> pedormance o/consfrucfion. Thaf I am authonzed by fhe owner oI this property fo peAorm the <br /> work lor which applicatio�t 's rnade and I compty wilh the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Dale <br /> �os os-ob Z <br />