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r <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAF2 STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �. <br /> 1���1.� li�. '�,,,,�. r' f�� i.�' i �i.:�� l <br /> PROJECTADDRESS <br /> �� „ <br /> Ik�.,.��' � I�'L,���e: r I�-� u �Lt.i,n_ � 11 � %�.i..�, .'7� I �'i') ;�5�:� i `i�', _;Z',`i—i>7r. <br /> Owner Mail Atltlress City StateRip Phone <br /> Tenant MailAddress City Slale/Zip Phone <br /> r <br /> � �1�� �/` i� :iiC �"c�� ILS��� /L -)E" C4°-, . ' � i! ' 4I �� )i� �� `IC ) �/1I''�lf-Y <br /> ElectriCal ContfaC�of Mail Address City State2ip Phone <br /> � 1 � q� , <br /> V:'� -t+7'-�--��r •i�i,�y�i ���� iL.Li,� K :) C'c' <br /> State License Number Contract Price af Work <br /> Proposed Use of Bullding Contact Person (Plan Review) <br /> Description of Work to Be Done� j�,.��� �)�w��: fY < L'-�r�;� �:,.� c,�, . . . <br /> ✓. . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 G. <br /> 1 hereby certdy fhat 1 have read and examined fhis application and know the same to be lrue and � L�U � _ `�2 <br /> conecf. A!1 provisions o/laws and ordinances govemmg thls type o/work will be completed ' -' <br /> whether specified herein or noL The granfing oI a pemuf does notp resume(o give authonty to <br /> violate o�cancel lhe provisions ol any o(her sfale or local law reyulafing construction or fhe <br /> peAonnance o/constmction. Thaf I am authonzed by(he owner o/this pmperty fo perlo�m fhe <br /> work Ior which a,.plication is made and I comply with fhe Sfate Con(ractors Law 18.27 RCW and <br /> 296200 WAC. <br /> � <br /> / . � . <br /> „ .� ��i - i: .� <br /> Signature ' Uate ' <br />