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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVtCES <br />3200 CEDAR STREET, EVERETT, WA 98201 G_ ���L� <br />425-257-&810 - FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �(i?�C' �I "(f <br />r�lo� s��,�. s�; S� <br />PROJECT ADDRESS <br />D.���o L_;��c-Y <br />Ownef <br />N�a <br />Tenant <br />1���.R <br />Eledrical Contractor <br />/u �-9 <br />State License Number <br />i�i' �- sz� �S Sr s� <br />Mail Address <br />Mail Address <br />Mail Atldress <br />:rc�/RC t /C�o:.�r! �0.'/...i <br />Pwposed se of B�il�ing <br />-✓c rY 7l <br />City <br />Cily <br />Ciry <br />W/{ "Si.O-i <br />State/"Lip <br />State.7_ip <br />Stale2ip <br />N �� <br />ConiraM Price of Work <br />,t)t�r 7i1/ <br />Phone <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />Description of Work to Be Done� -1.��5 "�� �l �T� ��'—d" � � `'', r�"�, <br />��%•is :t /.�,1,�.� <br />� n�� � ���"! _ =�J�-c'=� ��. <br />��i•.c.CS=�` /y .� t�c�(liS <br />/ � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEVNAYS, MC OR AC CABLE. <br />w <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily (haf I have read and examined th•'s applicaticn and kno�v fhe same to be Irue and <br />co�rect. All p�ovisions ol laws and ordinances govemrng Ihis type of wo�k will be completed <br />whether spec��ed herein or noL The granting o/ a pe�md does notp resume fo give aufhority to <br />violate or cancel the prov�sions ol any o(her state or loca� law iegulating construchon or ihe <br />per/ormance ol cons(ruction. That I am authonzed by (he owner o/ this property ro perform fhe <br />work /or which applicalion is made and 1 comply with the State Contracrors L2w 18.27 RCW and <br />296.200 WAC. <br />y�,.,iCC� f�-C �� <br />'� �// ��F'J <br />FEE <br />i, <br />�� <br />r_ <br />/�i L� U - � C� <br />6 � <br />r�8c'�I-G "!� <br />