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/ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARF ACCEPTED FROM 8 AM TO 4 PM <br /> �i�n�� l <br /> ���L'>�/ .L `'o/ Ln� <br /> r <br /> PROJECT ADDRESS <br /> I�u�,Gs�ly �-�-5 �� (�oKllb r.��,�lft; w� 95�6 yzs ar�-36P9 <br /> O ne� hlail Address City Stat=/Zip Phone <br /> Tenant A1ail Address Ci�y Slate2ip Phone <br /> �Gri�c� � ��(fl'rL 5�(y �l�'�}l/1� /��: �L .��t+r[.�f G✓/4-. 9D'dS'� �l?.f'35'S�7b�J <br /> Eleclrical Conlractor Afail Address Cily State2ip Phone <br /> �/IA'�'i1vU-�f)�i+� tlb c��.()OJ <br /> Sla�e License Number Contracl Pnce of Work <br /> ��1�� <br /> Proposed se�of Duilding Conlacl Person (Plan Review) <br /> Descriplion o(Work lo �e Donc: ��'L ti�� yl�i')(� S� r-t' ��-,'�t-X dL�C'}f- ��'�^.�C. <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 /> 1 herehy certily fhat I ha��e read anAexamined fhis application and know ihe sarne fo be f�ue and <br /> correcf. All provisions ol laws and ordinances govemmg this type o/work will be complefed <br /> wAeiNer specibeAherein or noL The oranfing ol a pemut does nof presume fo gi��e aufhonty fo <br /> violate or cance/fhe provisions ol an��other stafe or local la�r regulating consfruction or the <br /> perfonnance of construction. That 1 am authorized Uy fhe owner o/this property fo peAomi the <br /> wo�k(or which app':cafi i is made and 1 cornply�vifh fhe Sfafe Confracfors Law 78.27 RCW and <br /> 296.200 WAC. <br /> i <br /> /„�/ ��- I -�� , , � - %�� <br /> Signature � Date rr1 C� / <br /> �it/ <br />