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` <br /> � - <br /> El_ECTRfCAL PERMIT APPLICATIO►'V <br /> CITY OF EVERETT PERIIIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 4�;,-257-8810 - FAX 425-257-8857—w�,vw.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> / �,S ���� /L.S 6 /" V �,> �!� <br /> PROJECT AODRESS <br /> / I <br /> ,� . n. � �^ .� r1 tk r,� ri,} -c_1 <br /> Ownef ail Fdtlress Ciry State�Zip Phone <br /> Tenant Idail Atldress Ci�y Stale/Zip Phone <br /> � <br /> � � .,r 71 �� .r /7 � �"! ` C �y1 C.� <br /> ElectriC31 Contraclor ail Address City State2ip Phone <br /> Slate License Number Conlract Price of Work <br /> Proposed Use of Building Contact Perscn (Plzn Review) <br /> Description of Work to Be Done: lN,i r c- /,� 1-'i-✓ /�JYr�� '<— <br /> NOTE: W IRING IN NON-D�VELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/y that I have read and exammed this applicaficn and knew lhe same to be true and <br /> cerrect. All provisrons o7laws and ordinances goveming this type el work will be ccmpletetl <br /> whether specd�ed herein or nct The granfing ol a permrt does nct presume to give au(honty to <br /> v�clate or cancel the provisions olany e7her state or local law regulating construction or the <br /> performance of construction. That I am authonzed by the owner of this property to peAorm the <br /> werk Por which application is made and 1 complv wifh the State Contracfors Law 18.27 RCW and <br /> 295.200 WAC. <br /> y.�/ /�i1 r, '" � <br /> ,-, ;,i ,�� y� <br /> SignawrA- D e � <br /> -�%/- � � <br />