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�. <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 / � `�D—� <br /> 425-257-8810 - FAX 425-257-8857–www.everettwa.org L['�� �Z ��'? � <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 6 PM <br /> �b�,� C�. li �crnra /� dP <br /> PROJECT ADDRESS <br /> C i�F`� e� E✓Qict-t- we�t{-F uJ�} <br /> Owner Mail Address City Stale2ip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> f) k S'f5-�� s��. P o HoX 8 8b .rr /3�rl�i�y�Iv., w � `l `d � 3 3 36o>ssisss <br /> EleClrical Conlractor Mail Address Cily State2ip Phone <br /> �� KS�S�� s����� l� ��oOo . �n <br /> Stale License Number Contract Price ot Work <br /> `�(t,e�� �P���n �nr-�1,.. �< <br /> Proposed Use of Building Conlact Person (Pian Review) <br /> Descriplion of Work to Be Done: ` ��u i'�QPrN c C�.'�S <br /> NOTE: W IRIVG IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE I�; RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � <br /> 1 hereoy certily Ihat 1 have read and examined fhis application and know fhe seme fo be true end G� �� 2 —U�� <br /> correcL Ali provislons ollaws and ordlnances govemmg fhis type oI work will be completed <br /> whether speci(ed herein or noL The grenting o(a permd does not presame fo glve euthonty to <br /> violate or cancel the provisions olany other sfafe or local law regulating construction or the <br /> perfomiance of consiruction. That 1 am authonzed by fhe owner o/this propeity to perfomt fhe <br /> work lor which applicsfion!s made and 1 comply wifh fhe Sfate Contrectors Law 18.27 RCW end <br /> 296.200 WAC. <br /> �� �1�� i2 -ro -in <br /> Signature Date <br />