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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwe.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> . ,�,�r, c 1� <br /> _. � � 7 �l� �-� i�t'✓`^�J;a� �-`1/�(,�=T' <br /> PROJECT ADDRESS <br /> C`i�) 3�S- ; ,, - <br /> _ , ., <br /> <_. <br /> ;;mi-��.� ������ Ss-�_ 5i�`L3 ���,�'� �}-�/��,,�� C�=i=�1T—�ti�A 7D��� <br /> Owner Mailllddress City State/Zip Phone <br /> ��1�1��L- <br /> Tenant Mail Address City Sta�e/Zip Phone <br /> `>l�fv�� <br /> Electrica�Contractor M11ail�ddress City State/Zip Phone <br /> Slate License Number ConUacl Price of Work <br /> . � � <br /> �L=`�1 �>��IJi1 ��L� — ����vl� <br /> Proposed Use ol Buildin� Conlact Person (Plan Review) <br /> �2 i <br /> Desciiplion o(Work to Oe Uone: F-=,, � i 1�� ��i; , ��`�V��' I L-�,�l:= ��,�i� <br /> /i���r��-�=� {� 1 <br /> NOi'[: WIRING IN NON•DWELLINGS IS REQUIR[D TO FEE <br /> �E IN RACf_WAYS, MC OR AC CABLE. <br /> I <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cati/}�fhaf 1 have reod and exnmined this applicafion and kno�v fhe same fo be fn�e and <br /> correcl. AU pro�asions ollaws and ordinances governing fhis fype o!work �rill Ge completed <br /> �t�hether specilied Omein or noL The granfing o(a perrnd does not �resurne fo give aulhonty(o <br /> vio/afe or cancel ihe �rovisions of any ofher stafe or local law regulafing conshuction orthe <br /> performance o!cons�iuc(ion. Thuf 1 am aufhoiized by Ihe o�+�ner o/this property to perlonn the <br /> work!o��rhich application is made and I compl}�with tho State Contraclors Law 78.27 RCW and <br /> 29G.200lNAC. �" <br /> , _- <br /> '-' �_ � lo � � G � �� ;u�,iG 13s <br /> . Signature Date <br />