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� � <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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I I�-�-1 � � �1�- �'�-U�, >r, �I�� <br /> PROJECT ADDRESS <br /> ��'�r i.n,0�'-- Jr�,. ��� �S'vk /l�5'1 ��t'luhial'/i� � , l�(.�� ��.y 9�/ <br /> Owner T_ Mail Address Ciry Slate2ip Phone <br /> ��— � ���-(-�"� , I I�(I `� (��� '�I/. �>F- #IO�i' ��� U..K�-- �'�6�7�'� ���, <br /> I enant Mail Addross City �TState2ip Phono <br /> � l(1f-;— <br /> ��'r�1 V f\�(}�l 7�(D� '�(J-1�/tff�5 t1 �Qr� L"Zl`{�l'��" l 1�--- ��2 '7?U�'�k,; <br /> � <br /> � ctrical Cor�tractor Mail Address City Stale2ip Phone <br /> ��;rr�l 1�.����� L<�� � �L� � o0 <br /> Sl License umber Cont act Pri of Worc <br /> � <br /> ��JC��Q�� <br /> Proposed iJse of�uilding Co tacl Person (Plan Revlew) <br /> Description of Work lo Be Done: 1 ��-�(�� ,� �� �� X 1{ � / 3/G r� � U r � /t�7/(�� C'll/Q,� <br /> 7 � <br /> ����� Q�I���j1(�a�' ���r',(�� 1�2(�tl,/1�"� ) y_� ' - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE7"f LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily Uiat I IiavQ read and examined this applicalion and know the same to 6e irue and <br /> correct. All provisions o(laws and ordinances goveming this type o(work will be completed <br /> whether specified herein or noL The granting ol a permd does notp resume fo give authority to � <br /> violate or cancel the�rovisions ol any other state or local law regulating construction or the � <br /> performance o/construcfion. That 1 am authonzed 6y the owner o(this property to per(orm the <br /> work!or which application is made and 1 compfy wilh the State Contractors Law 18.27 RCW and � <br /> 296.200 �C), ^ I <br /> i 7 . <br /> ��'� �� � �7 �� � �,,� <br /> `Y ignat r Date <br /> ( <br />