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� <br /> EL�CTRlCAL PERMlT APPLICa►TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 G - FAX 425-257-8857 -w�wr.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `!D`I S�t:vt=,�s D cti�� i�(yt9. Sc� iYF J'� <br /> PROJECT ADDRESS � <br /> Owner 6�ad ndd�ess Ciry StatJZip Phone <br /> �S) (LJ{a ll� l� —I C I�� `> <br /> Tenant rdad ndnres Ciry Siale2ip Fnone <br /> i���3r7(FC�C'Fs'i �Cfic i �e Rc x iiL- �'� '�r�-'i �.�r� �i�D 3s :2sy 5'h 7/,Z <br /> Elecincal COntroGtor Mail Add�ess Ciry State2�p Phone <br /> ����t��F�G �7n 5� f' 300, �-C _ <br /> State License Number Contract Price of Work <br /> lC�/</lil�.�'/7/�il <br /> Proposed Use of 9uiltling Contact Person (Plan Rewew) <br /> Uescnp6on of Work to Be Done�. l�! 5� �� ��� ���� �" ����L�l// }Lr� /N$I/y /�G 1 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certdy lhat 1 have read and ei,nvned(his applicahon und know fhe sarne to be true and <br /> r.orrecl. All provisrons o(la�vs anA ordmances oovernmg Ihis type ol�voik�wll be ample(ed <br /> whether specd�ed herem or not. The granhng o/a permd Sr�s not presume(o give authonty to <br /> w�late or cancel fhe provisions oI any ot6er stafe or locai!au�•^gulaGng construchon or the <br /> perlormance ol construc6an. Thaf I am au(honzed by Ihe c�•rner ol this property!o pedorm Ihe <br /> work 7or�vh�ch appbr.afion is made anrl l comply nafl;the State Contracfors Law 78.27 RCW and <br /> 296200 WAC. <br /> } ' ��` / r <br /> �LL.!'. �i[��` f �CJl..�ll-.�� �'���I� '"�i C"� � � <br /> SignaNre Dale <br /> ��i <br /> � � <br />