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'. � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES _ <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �J —7.1-OC� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org �,O 6��� " ! <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> J <br /> �' I1(n �l z� r� Dr S1Z <br /> PROJECT ADDRESS <br /> �l jS'� 2�p� <br /> �,P //(o// Z3r0 �5tj ��vfitr� G,N�' 9� uP' Zs'3g <br /> Owner Mail AAdress City Slate/Zip Phone <br /> Sgn� <br /> Tenant Mall Address City Slate2ip Phone <br /> l/ r►rdA-,�' ��av rrkr.,��r c,-�< I'k•+� .E�U.� �.� �`d�zo� y U�;z_ <br /> alle�• <br /> Electrical onl�actor Mail Address City State/Zip Phone <br /> Cl�i <br /> VA�L ,E�� /4l N�} �/s'ou <br /> State License Number Contract Price of Work <br /> ��S���n �7J'� <br /> Propused Use c�f Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: ���'f✓`�'(^ O1�N' /�A 1^UN h ��'� S w�rYl�I���� <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 /> 1 hereby certify that 1 have read and examined this applrcatron and know the same to be true and <br /> correct. �+11 provisions o/laws and ordinances govemmg th�s type ol work will be completed <br /> whether specified herein or not. The granling of a permit does notp resume to give authonty fo <br /> violate or cancel the provisions o(any other stafe or local law regu/ating consfruchon or the <br /> peAormance oI construction. That 1 am authorized by the owner o/this property to per(orm the <br /> work lor which applicafion is made and 1 com.pty with the Stafe Contractors Law 18.27 RCW and � <br /> 296.200 WAC. D <br /> ,�. �/�/d� I � 1I � <br /> SignaWre -��e V�� 1 / <br />