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. 4 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, 'NA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '- ���.�� �ll��,J�=�rr�--t�_ �,/.��� l q'�zL��� <br /> PROJECT ADDRESS <br /> �� � ' � <br /> �,�,L� `�' ��' � -1'l._I ►'�� � `_�1(��t-�C� �� ����/�����%� I L <br /> Owner A1ail Address City SlaleiZip Phone <br /> -R_-�C-:/'���7-' I <br /> TC�3111 Idail Address City Slate/Zip Phnne <br /> =�l—Z� i/������ _ <br /> Eleclrical Conlractor Mail Address Cily State2ip �'hone <br /> Slate License Number Conlracl Price o(Work <br /> ` � � �Il;'� 1^ _ - <br /> Proposzd Use of Building Conlact Person (Plan Review) <br /> Description ot Work l0 6c Done: � �I :�`,�f�� . �l ���__��-.1 �rti�/ � <br /> .� l���l ,�' �`1 ',`�__ <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC UR AC CABLE. <br /> � CITY OF EVEP.ETT LOCAL SALES TAX CODE IS 3105 <br /> 1 f�ereby certily Ihaf I have�ead and exarnined fhis,ppli�afion and Fno�t-the sanw ro be frue and <br /> coi�ect. All provisions ol/aws and orAinances goverr�ing this fype ol work�sill be completeA <br /> �rhefhcr specilied herein or noL The,qranting ol a pennd does nof presurne to give aufhority to <br /> violale or cancel the provisions olany olher sfate orbcal law regulafing construction or the <br /> perlonnance o/const�uc6on. That I am aulhoi�ized by fhe o�vner ol this property�to perform the <br /> woi�k lor which applicaJion is made and 1 corrip��vifh fhe Sfafe Confractors Law 78.27 RCW and <br /> 296.200 WAC. � � � i <br /> � ��' ; . � <br /> , , � � �, ,�, .�,�,_ <br /> �� � )T� / / � <br /> , , <br /> � "i' %� '��� / G�;, - I �y <br /> naWr � " �� Date � <br /> ✓ / �� <br />