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_ .., <br />,:: _�,"�; <br />� <br />..,:M. _ . ' <br /> �LECTRICAL PERMIT APPLICATiON <br /> CIT'�' OF EVEacTT PERMIT SERVICES <br /> 3200 CEDAR S'i REET, EVERETT, VVA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> W 63a. �o2cs� �� , <br /> PROJECT ADDRESS <br /> 1F���� ��.os, 3�aa ��►t �uE. ti�. �E���-r W� ��2oS tizs-�36o <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Mail Address Cily Slate/Zip Phone <br /> Electrical Contractor M11ail Address Ciry Slate/Zip Phone <br /> State License Number Contract Price o(Work <br /> Proposed Use o(Duildiny Contact Person (Plan Review) <br /> Descriplion of l�Jork lo Be Done: � l��__�O.)�,V <br /> f._ <br />� <br /> � <br />� i <br /> j <br /> -:+ <br /> NOTE: WIRiNG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I:ITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heieby certily thaf 1 have read and examined this application and know the same to be true and <br /> correct. A/l provisions o/la�vs and ordinances goveming this type o(work will 6e complefed <br /> whefher specilied he�ein or noL The granting o(a permd does not presume to give authonty to <br /> violate or cancel fhe provisions ol any ofher stafe or local la�v regulaling consfruclion or the <br /> perfonnance ol consirucfion. Thaf I am aufliorized by fhe owner o/this propeRy to perform Ihe <br /> work lor which application is made and 1 comply wi i the Sf e Contracfors Law 18.27 RCW and <br /> . , 296�Q0 WAC. <br /> �\ � I "25'a(D <br />� � ' <br /> 6ignature Dale 1 <br />� \\ / `���\�\ <br />� \ � U <br /> — ---- <br /> --�,:.�:,��.�.�,.�.,_�...�..:..�,..q�.,.�.�...�� _:_�,- <br />