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( 1 <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857–www.everettwa.org I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I <br /> �� IC 1 �23��- �L,r l,J �' !Oj- <br /> PROJECT ADDRES�i <br /> C� w i�y5 <br /> Owne� Mail Addrecs City State2p Phone <br /> �lXVc. n�C �- �� �J .� ��� S�C�� .��3'`� �^. W L�:lGtl � I.J/� <br /> Tenant MailAdd�ess City Sla�elZip Phone <br /> �V��;l r�... �L't�,��,,�:.�,� . �„ t .S Y�L'�� y�; -, �� 5(�..�e G✓/r `l�S� �'1 <br /> � Stale/Zi Phone <br /> Eleclrical Contraclor Mail Address C��Y P <br /> �L�i= ��L 1��-L/15 l-IZ `li S� C> <br /> State License Number Contract Price of�Nork <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of VVork lo Be Done: �'`��`/ �'i1i'- �5�`' r <br /> NOTE: WIRING IN NON-DWEI.LINGS IS REQUiRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 !� <br /> I hereby certily(hat 1 have read and examined this app�:cafion and know the same tc ' _ :�� 3 and �� DU�. — U' Q a( <br /> correcL All provisions ollaws and ordinances governmg this type oI work will be coi,�pleted <br /> whether sper.rfed herein or noL The granling ol a permd does not presume to give authonty to <br /> violafe or rsncel fhe prorisions of any other sfate or/ocal law regulafing construction or the <br /> pedorma�ice oI construclion. That 1 am aulhonzed by the owner o(this propeRy to peAorm the <br /> work!or which applicafion is made and 1 comply wifh fhe Stafe Con!ractors Law 18.27 RCW and <br /> ' 29fi200 tNAC. <br /> ��/ . . � � � <br /> i�ti:%/ > . �—_ �,�15//� <br /> ' Signa�ure Da�e <br />