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l � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org `y��`� <br /> 7 <br /> APPLICAT�ONS ARE ACCEPTED FROM 8 AM TO 4 PM !-J �g`o.7d <br /> (- <br /> =��O �T�.,.�e,r S�ee;� <br /> PROJECT ADDRESS <br /> �xP�C' �)M�`���1�. �flQ�,dp1�1dI'�� S� �'.�dPAc �A 'l�o ��_ <br /> O,rme� A1ailAddress � C�ly StatelZip Phone <br /> � ', l l"\2CA <br /> Tenanl MailAddress Qty StalMZip Ph� <br /> $�aa <br /> G„��wr, C n�.4r��S c 9c c� �-I�o'�o ►l�'�' �3s ��ba4 C�-i�e. l�4B4�i se3y <br /> Electrical Conlractor Ma�AAdress Cny SlalerZip Phone <br /> ����- .�sa- ��� c.,ua��c.���a� � �5� _ �' - <br /> State License Number Contrad Price of Work <br /> IMvt:nl.... �/vlA'•.4� �c � � �n.0 Cnw) <br /> pF'oposed Use of Buil�ing Contacl Person (Plan Review) <br /> Description of Work to Be Done: <br /> � �S <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE` ^ <br /> BE IN RACEWAYS,MC OR AC CABLE. ��v�I <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have 2aa and examined fhis applicalion and know fhe same fc 6e frue and ���O G{ �l�rj� <br /> conecf All procisions ollaws and ordinances govemmg fhis type o/work will be completed l lJ I� <br /> wlrefher speci6ed herein or noL The granfing o/a pemvf does not �esume fo give aulhonty to <br /> violafe er can�1 fhe provisionc ol any othersfate or local law/ec�uPa�ing consfruction or Ihe <br /> peAomiance o/consiruc(ion. lnaf I am authonzed by tY,e owner o/fhis property to peAorm fhe <br /> work/or which application is made and 1 comply�vifh Ihe Stafe Conlractors Law iH.27 RCW and <br /> 296.20 AC. <br /> /��/ �— ,�/((�2v1 2_ <br /> / Signature Date <br />