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q, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ab �o <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g- / <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org C�O0 8 �b 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /.�z� ��� �v�. <br /> PROJECT ADDRESS 'T<1S ./"�� � <br /> �J,p/d�/ �c�� lo�.�P /��'�'�h' �l�F�'61T !¢�.��/ <br /> Owner Mall Address City Slale2ip Phone <br /> Tenan� Mail Addmss Cily Stale/Zip Phone <br /> :�1 � <br /> Elecircal Conlractor Mail Adaress City StatelZip Phone <br /> Sla;e Licensu Nurnber Contract Price of Work <br /> Proposed Use of Duiidin� Contact Person (Plan Review) <br /> � <br /> _/�I, ,/ <br /> Descriplion ol Work lo De Done: (j� �"T7�/�����N <br /> � <br /> NOTE: WIRING IN tiON-DWELLMGS IS REQUIRED TO FEE <br /> DE IN RACFVVAI'S, A1C OR AC CABLE. <br /> � <br /> , <br /> CITI'OF CVCRE?T LOC�\L SALES TAX CODE IS 9105 <br /> I hereby ceriiJy thaf I have read and exmnined this ap��lication and kno�v the s3nre fa be frue and <br /> corrocL All prrn�isions ol la�•is and ordinances goreriung this type o(work wil!be complefed <br /> u�hefher spec�Iied hercin ornoL Tfte�ranfing o/a p�nnd does nof �iesumo!o give aulhonty to <br /> violafe or cancel the provisions ol.�ny other sfafe or focal law re�ulafing consWcfion or the <br /> pe�fonnance o/con (ruchon. Thaf 1 ant aufhorized by the omner ollhis prope�ty fo peAonn the <br /> �vorh Ior�vhicl�al>(�cafion is made andJ comnl}�itl fh�tate Contr�;fors Law 18.27 RCW and <br /> 296.200 W / � <br /> � �� � -�� ; o ,��_ ,�� <br /> . <br /> Slgnalure Date / / <br /> I <br />