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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SF�RVICES <br /> 3200 CEDAR STREET, E\�ERETf, UJA 98201 <br /> 4�5-257-8810 - FAX 425-257-8857-www.ev- �eltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> r i til � l �t`� A,��� SC � (� - �o� <br /> PROJECT ADDRESS � <br /> � �I <br /> � 'tJ'i(��'�� �- ' t �.n�'�'. �.u�n , <br /> � cc<< �{ +5 (�O. '�e.t Svv��,�« �.�� 41,A �c`�� `'T I <br /> OWnef hlail P,ddress Cily Slate/Zip Fhoce <br /> ��1COJC'- ,�-X"'��S IIY �� ���� �JC_ �� '#�j"��.� ��f[' 1�, WJi 1 (J /�-'�� �' <br /> Tenanl A1ail Address City Stale2ip Phone <br /> � ,�� ��C� � � n �/�' . <br /> �C?_Cf'li /V�.Ci�f �I��JI �� S�IC�tij � > Jc �1 F'( CtX'JC�f'! W/r "nI�LC� 'i '. <br /> [leclrical ontractor MailAddmss Ciry Slale2ip Phone � <br /> � El�.(Z�r',til�rf j'j L j ( `� C) - � <br /> Siale Lir,ense Number Conirecl Price of Work <br /> � <br /> �_��.�:,u��� ,4 � cGf��,�cr�s �����, �� <br /> ?ropusrd Use ot Buildinc� Contacl Person (Plan Review) <br /> Description o(Work lo Be Done: -1����yc, ( � �-���, �; (�� �1 j -'�t OcJ�4�CC1 G�c�l <br /> � <br /> E� . < < . _.. i !f! t,« �C'-��� L�.Ck� '_' �n..c.�c'�^� �n nCJWc'- .!` Ct' 7- ����wc' CJ� <br /> I'���C< ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CHBLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I hereby ce�tily fl�at 1 have read and examined this applicafion and kno�v the same to be lrue and <br /> correcL All provisions ollaws and ardinances goveming this type o(�vor;c will be completed <br /> whether spea6ed herein or�ioL The gram'. g of a perrnd does not resume to give authonty to <br /> violate or cancel the provisions o!any ufher sfate orlocalla�v re�uPfing construc6on or the <br /> performance o/construchon. Thaf 1 am acU;�rized by Ihe o�vner oI this property to perlorm the <br /> wo�k Ior whkh application is made and I ccrnpl}�with the Sfate Confracfors La�v 18.27 RCW and <br /> 296.200 61�FlC. <br /> G:".ti :�-�f. �CL lti c[/l. , � /Uo�.�,titbP.i-�G�v� � <br /> S aNre Date ; //-�j <br /> �(� � / <br />