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� <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES / <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C�- a I�� <br /> 425-257-8810 - FAX 425-257-6857-www.everettwa.org C�D 06-��,3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��/`� � �1 ���� �� JC I �. <� < < � �� =��� �� �� <br /> PROJECT ADDRESS <br /> (���:,��� �G.( (��� ��`���'I �„Zvt�l 1/II�V� l�c � �- � i �..�, ��'�i J V � ✓.�( �� '/� � <br /> Owner Mail Addross Ciry State2ip Phono <br /> Tenanl Mail Addross Clly State/Zip Phone <br /> /�ift ��� l- l.. .�p .� •_ ��U (���� ��� � .�i 4� �� i r�9 �llli�. ( ��7: i g . G�/�f <br /> Ele rical Conlractor��f��.r� ,��, Mail Address City StalelZip Phone <br /> �vr�i�E � c j'VV � �'� I.� � �I �I�! �� <br /> Stalo iconse IJwnber Co tract Price o(Work <br /> ��� ti��, �� �� ;k�� ��y <br /> Proposed Uso of Building Conlac�(Plan Review) <br /> Doscr'pllon o(Work lo Do Done: �-�� � �� �� l �'"t-��� �l C- � � ��l V� � � <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 hereby cerfily fhcl f have maA and exarttined this applicafion and know fhe samo(o bo fruo and <br /> correcf. All pruvisions ol laws and o�'dinances goranmg this type ol work will be completed <br /> whefher speci(icd herMn or noL The c�ronfing of a pernuf does nof resume fo give aufhonty to <br /> violcle or cancel!he pro��isions of any o0ier sfafe or locol law regu�tin�construction or Ihe <br /> performance o/constn�ctionirThat I�m aufhorized by the owner ol this property to pwfomt Ihe <br /> �ror.4/or�vf�icli applicntion i"s nmdo and I comply wilh Ihe Stafe Conlracfors Laiv 18.27 FC W and <br /> 29G2001hAC. / <br /> I , �J / <br /> ' � �� r �� ( � <br /> � ;�� % ;��, ,; <br /> S�i iaWre ---_ Dale <br /> , ' 70� ` � � , <br />