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f, ���'�,��t� <br /> � � ;� ELECTRICAL PERMIT' �►PPLICAT!ON <br /> CITY OF EVERETT PERPJIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257�•8867 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTE� FROM 8 AM TO 4 PM � �9�O <br /> —�-1 ' ';'�lh�7�O 3 (� <br /> �� � `J � � � i/Z:�L� <br /> PROJECT ADDRESS <br /> i IJL� / i; <br /> �-_,��.l �-� �� ' � - <br /> Owner � Mail Address C�ty Stale/Zip Phone <br /> � �"� � <br /> Tenant Mail Address City State/Zip Phone <br /> � `7�1�z �i <br /> t; (C� l�! �I��-G/� �L�. ����G/,:�. ,�l ��� Q �I, I r.� r�� . . C l <br /> Electrical COntractor Mail Address Cily Slale/Zip y,� S Phone _ _ .r- <br /> ' � 37-s3 .. <br /> i�'l�l< �. � 1 `� y��� ��"� <br /> State License Number Conlract Price of Work <br /> � <br /> �� � /Sc=h/ J?l: , � <br /> �;t., �� r-,, < i r,ti�•-�T <br /> Proposed Use of Building Contact Person (Plan Review) <br /> / /� �/ <br /> ! � ` -� <br /> Descriplion of Work to Be Done: "�� � � � �''-� � `2 � " ° n j��?t`� �'� � <br /> �, _� .�� --, '� <br /> � ` ��� ✓�7J"�a C� ✓�'� ��"r� � �4 Y���/�� /_�' � � / <br /> NOTE: WIRING IN NON-DWEI,LINGS IS REQUIRED TO FEE <br /> , 8E IN RACEWAYS, MG OR AC CABLE. <br /> I <br /> CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 <br /> �� �v��" �3� <br /> 1 hereby certily that I have read and exarnine this application and I<now the same to be frue and l <br /> wrrect. All provisions o(laws and ordinanccs goveming this type o(u�ork�sill be completed <br /> t�,�iether spec�lied herein or noL The granting of a permd does nof presume to give aufhority to <br /> viof:�tr, or cancel the�rovisions of any ofher state orlocal law regi�/ating construct�on or the <br /> per(crmance o(construction. Thaf 1 am autlionzed by the owner of(his property to peAomi the <br /> wnrk�or which application is made and 1 comply�vith the State Cor�tracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �' % / <br /> � !�� � �I'���> <br /> Si�naWre Dafe <br />