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o:��:.�� <br />;._ <br />; �;_., -- <br /> �� I���� y �z, ��� _, �- 5�_��� , << � � <br /> ELECTRICAL PERMIT APP'LICA'I"ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, V'!A 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> / D i Z -S �D-7 ����h S i SC <br /> PROJECT ADDRESS <br /> � <br /> �.. % `� �ARr C ���rk <br /> Owner 61ai1 Address City State'Zip Phone <br /> TGnant Mail Address City Stale/Zip Phone <br /> ?LJ <br /> �,���,a N1 ���E2CtEc �`�ZN Cro�d A,(�Ei2 �ree ���c� 1:4,�a9�"�S 33 ►��s7Z_ <br /> Elecirical Conlractor Mail Address Ciry State/Zip Phone <br /> 1l�e��n n.,e59 i,��� <br /> State License Number Contract Price oi Work <br /> �e s� .��. �,�_� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work to Be Done: /v F � /'�U n'1� W i 2���6- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> I <br /> 1 hereby cerfily Ihat 1 have read and examined this applicaron and kno�v the same to be frue and <br /> correcf. All provisions oflaws and ordinances governmg th�s type oI work�vill be complefed <br /> whether spea6ed herein or noL The granting o/a perrrut dces not resume to give aufhonty fo <br /> violate or cancel(he provisions o/any ofher state or local law reguPting construc6on or the <br /> perlormance ol construction. That I am authorized 6y fhe owner ol this property to perform the <br /> wo�k for�vhich application is made and 1 comply wifh the State Contractors Law 18.27 RCW and <br /> 296.200�VAC. <br /> ,y// �' 2 Z aS <br /> Sign re Dali� <br /> J��� _ / � � <br />