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� <br /> �' ; <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �{ � 1��`-�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��j d j{ ��� <br /> 425-257-8610 - FAX 425-257-8657—www.everett.va.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT &CREDIT CARDS ARE NOT ACCEPTED <br /> i � � <br /> I��[l /���C�'�' u� . CG'�i'�-t t <br /> PROJECT ADDRESS <br /> �17�� <br /> , <br /> i� l� <br /> Jc�E � �r'Cl: %l�'�%' �c�� �:c'r' �lue �l:'���r'tC L{/%f `i���r-i3�y 4 ��S' <br /> Owner Mail Atldress City State/Zip Phone <br /> Terant M11sdAtldress City SlalelZip Phone <br /> LleclriCal ContfaCtOr A1ai1 Adtlress Ctly Slate2ip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Rewe�+7 <br /> DesaiptionoFWorktoBeDone-. �l(OL'{ ��'('f� /l���L� 4���������� / L� �/i(.�C�(/��i/�'�(�!-� — <br /> �[ �Ur � i i 1 o i�'�R il/E^c� l l!<�/ti' /�vr'<i�'I� �X a' l/r�r� _ <br /> � lJl-��("I' ��c;SE � '�lr�c ('r �'tac-Jc�/ �L- rt'i �'i�,� cvriiu� 4. <br /> J, ��� �ti��(�i� : C�����ti<<ctz-�� Ti3� . <br /> , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS. MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SAI.ES TAX CODE IS 3105 <br /> I lie�oby cerlily fh��t I h�ive read and ecanuned Ihis r;�Phc,�tion and know the same to be frue�nd <br /> �:nrrect All provisions o/larvs and ordinances goveinm9 fYis type o/�vork�t�Jl be complefed <br /> �vhethor specA�eAhe�e�n ornoL The granhng o/a pemut does notp resumc fo give authonty to <br /> v�olata or cancel the provisrons o�any other slato or lor.al la�r ro�ulafing consfruchon o�!he <br /> perfo�manco o/consfruchon. Tha(1 arn authonzed by fhe owner o/thes propertylo pmiorm iho <br /> �rorl�for wluch app6caLon�s rnade and 1 comply u��th fhe Sfafe Confraclors Law 18 27 RCIN and <br /> ?96 200 WAC. � <br /> S�gnaturc Dale <br /> j��C-'` Cf�l!' <br /> � — <br />