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f <br />n <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 <br />.�3�a Roc�e�'¢L[er ave. <br />PROJECT ADDRESS <br />K�D'b�ear7nc �ILa�� �'2ccJuc..�st. �rtle- E�e.f'�� g8a03 'ao�o•aao-�o <br />OwnBf Ma�l Atldiess C�ty State2�p Phonc <br />Tenanl <br />Mall AEOress <br />Clry <br />SlaleQip '. Pnone <br />Pe� ��ma�ce �JecfTic. �3U7 a8and Pl Nc,J S�anw �-�� G�A ��o•� <br />Eleclnwl Contrador Ata�l AEO�ess C�ry Slate/Zi0 Phon� <br />i c2F0E I Cll9�� <br />Slale license Numbe� <br />�Uecc� �;��yle �am�lc..� <br />Pwpo5e0 Use ol BwlJing � <br />Oescnpuon ol Work to or pone: <br />NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO <br />� DE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS J105 <br />comrac� Frice o, work . <br />Contact Pc ,on (f'ian Review� <br />FEE � <br />�l0 - 60 <br />I hore�y carlily fhal 1 have reatl and erammod !h , app��cafion and know fnu same fo De Inie and � / <br />correcf. All plovis�ons of /aws and ord�nances govommg fnrs lvpo o�! Nrork will De mmplered y/, ��"O / `( I/� <br />whot�er:peulratl horem ornof Tho granhng ol o pormd doos not msumo fo 9ivo avthonty lo � j !.. Y' <br />nolale or cancal fho proviYons Of any other sfafc or �ocal lew regu/ohng construchon or fho lL / <br />pedormanco o! Constrvcfion. Thaf I am authonzed Ay ��o owne� ol lhis pmpony lo peAorm f�e ' <br />woM !o� wh�c0 apphcafron is natle and 1 compiy w�ln fAe Stafe Confracfors Law 1B 27 RCW and <br />296 200 WAC. <br />� �.t�orY� C�/d 3�� <br />u�� 9 <br />