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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, V1�A 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �f � �! �l`�-''� :�— �:/_ �;�c�,�/�� <br /> PROJECT ADDRESS <br /> YA�I �:,� ; � ..,, �ite�(e�ri srf W� y,l f�3.'rYY � <br /> OWner Mail Addross Ciry Slate2ip Phone <br /> TCnaM Mail Address Cily Stale/Zip � Phone <br /> l 4��Gc i :i:c 7KIc '1 il.� 1; i� Sj.,V1U, _��`rt/vWsr'J lit�/}' �n�: j,.) �u,: �5�- � <br /> — ._ ?�8_ <br /> Electrical Conlrac�o� Mail Address City Slate/Zip Phone <br /> _�;l f f,+ t " i�� '— i 11 �CG•'G'.OG <br /> Slate License Number Contract Price oi Work <br /> IA�_i� �'i�/.�y <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work to E3e Done: �GL'f}' �LL"�7'��C��-- S�y�L� UrG�.ni{��E. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF�VERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that 1 have read and exarnined fhis application and know the sarne to Ue true and <br /> correcL All provisions ollaws and ordinances goveming this type o(work will be complefed <br /> whether specilied herein or noL The grantinc�of a pemut does not presume to give autlionty to <br /> violafe or cancel tlte provisions of any ofher stafe or local law regulating consfruction or the <br /> per(ormance o/construcfion. That I am authonzed by the owner o/fhis property to pe�fonn lhe <br /> work lor which applicafion is m�de and 1 cornply with the Sfate Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i I ' '1 <br /> ���� l�'�'� ' � �11�-��� � :;��� _-� �;L� <br /> Si�nature " Dale � <br />