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{� • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 U - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �> > <br /> 7�J � �3 J; r L�t' � ; <br /> PROJECT ADDRESS <br /> �,%c; i�� -t ,/ `'L,�,,., <br /> Owner Mail Address Clly Slate/Zip Phone <br /> �7�.'1��;..0 L��it %� <br /> Tenanl Mail Addres; City Slate/Zip Phone <br /> jV�P/'� r j=!�c f�,< �''12ZC�1 �'Yhdiw,:% '�fl/c�i ,�ib'krLKo CJ�; `ly2ZS (�-/'ls')3�5'-`S�e�O <br /> Eleclrical ConUactor Mail Address City Slale/Zip Phone <br /> � <br /> � Hir�'r�T�'1 v ��y 6 � � �(�O � _ <br /> Stale License Number Contract Price of Work <br /> �q�i. ; <br /> ��! ,C�='/ u��ii'� l1^c.'Sr <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> � L <br /> Descrip�ion ol Work!o De Done: � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> � <br /> �7L <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby certily fhat I have read and examined fhis ap�lica(ion and know the sarne fo be frue and <br /> correcL All provisions ollaws and ordinances govemmg lhis type o/work will6e complefed <br /> whether speafied herein or noL The grantinc�o(a ponnit does nof presume fo give authonty to <br /> violate or cancel the provisiens o/any other stafe or local law regulating consfruction or fhe <br /> performance o(consfruction. That 1 am authorized by the owner of this property to pedomi the <br /> work lor which application is made and 1 cornply witb fhe State Cunfractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> - �"� 11 - �_G `l <br /> Signature Date -� � <br /> " �/a - 3 <br />