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� � <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 /> 1 <br /> �1 -� 3� � '�� r'I✓Q ' ' L <br /> PROJECT ADDRESS <br /> �� i� 1- ��C . <br /> Owner ldail Address City Stale2ip phone <br /> Tenant Mail Address City Slate/Zip . Pho e <br /> (��,5,� <br /> VII� iNG rle�-Ir� ��-,nc, ���-C- Gas-�-, ��, /v�. n��� s�, l��>, t,.��_ `1f�a7G 't'�c <br /> Eleclrical Contractor Mail Address Cily � Stale2ip Phone <br /> / r� � <br /> aj.,lkTl� (�1 ��S.a<T — <br /> Slate License Num6er Contract Price of Work <br /> Proposed Usc of Ouilding Contacl Person (Plan Review) <br /> Descripliono(WorkloBeDone: I�kC� �� � �C�(�/ Glv�n �{l� ypf'�/,�jJ . I��I'1(��^(� ��9�('� <br /> � � '-�"l� � . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 he�cby ce�tily Ihaf 1 have mad and examined fhis applicafion anA know fhe sarne to be frue anA <br /> conect. All piovisions olla�vs and ordinances,qo��ernmc�this lype ol work will be completed <br /> whefher speci6ed hcrein or nof. The granting ol a pernut does not �resume to give aidhonty fo <br /> violate or cancel fhe provisions o/any other sfate or local law regulafin�consfrucfion or Ihe <br /> perfonnance o!consfrucfion. That I am aufhorized by the o�sroer o/fhis property io perlornt fhe <br /> work lor�vhich application is made and I cornply wifh the Sfafe Confractors Law i8.27 RCIN and <br /> 296200 W�1C. <br /> ..�,. ,_ �_-- C����/ � <br /> r / C^ � <br /> �` Signafure �ale I / <br /> ,. �� y�`t <br />