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�. <br /> _' '� <br /> '•'Si� � <br /> "�Y ! <br />"�fl�' .;�... <br />"'` � 1� ELECTRICAL PERMIT APPLIC/�TIOIV <br /> ,.�..�_.. , <br />',� `' " CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRECT, EVERETT, lNA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br />- ' � � APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPT6D <br /> f� <br /> � �t�� <br /> o�� <br /> � / � T ., � � ,��, <br />'� , ���?� � I 7 G �� %' � �� ;I `i i. <br />"'�`"�� ' PROJECT ADDRESS <br />„_ <br /> r'� <br /> '1.. <br /> .'' <br />� � - Owner Mail Acdress City State/Zip Phone <br /> t,:-.�;��.��: <br />'.�s�, <br />;�: <br /> Tenanl Mail Addrees City Slale2ip Phone <br /> I� R/1 I r� I �( <br /> i <br /> Y1�,1,�Iul "' �1 4�i li_.. fC'.C-'T�'IC <br /> E�IP.otrical Contractor Mail Address Ciry Slale2ip Phone <br /> 1' <br /> tate License Number Contract Price of VJork <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work ta Be Done: <br /> NOTE: WIRING IN NON-DVJELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 1 <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> I hereby cer�ily that 1 have read and examined fhis application and know the same to be we and <br /> correct. All provisions ollaws and ordinances govammg this type of work wi.'I be compieted <br /> whether spea6ed herein or noL The granfing o/a permd doe.,not presume to give aufhonty to <br /> violate or cancel fhe provisions ol any ofher state or local law regulafing cunstruction or the <br /> peAormance ol constructwn. That I am authorized by fhe owner of th�s property to psrform the <br /> work lo�which application is made and 1 comply with the Sfate Contracfors La�v 18.27 RCW and <br /> 296.200 V:�AC. <br /> 1�j/�— n�n�^ <br /> �,: . /C�� �/'rj��c �-> Ll' L� ' , <br /> �ig�tuF�` ` � Date <br /> �� �. � <br /> �- C�7 O�_� __ � <br /> '° <br /> u <br /> ti — <br />, - . - <br /> ; <br />� - - .._ <br />