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i <br /> ELECTRIC�L 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 - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> �� � � 1 l t�i�u e �� - � <br /> PROJECTADDRESS y2S 3�7� <br /> `;'1'1 ���e ���� � 305` l � � v� GtJ �uev�ll (,�� �/d'.zDy I <br /> Owner Maii Address � Citv State/Zip Phone <br /> T�t Mail Address City State2lp /���/� Phone ' <br /> � � 4� <br /> � �—`r'w�'1 1=�-E ���\L �-e C (�(J./� ` ��� �D 3 I <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ��cq j�,� p G <br /> ��%�'Y� �' �A �ZBC I � (j Il ',� �� ��(� �^ <br /> Slate Lice—' nse Number �r�l��I Contract Price of Work <br /> C V ���rr�l 7� "( / 0 / <br /> Ji�� ��` -c ��i _ <br /> Proposed Use of Buildng Contact Person (Plan Review) <br /> DescripCon ef Work to Be Done: ��'��d Zd � /� ��1� � � S'e U U� L`' <br /> � � <br /> : �� � � �.� <� � . � ��,� , � �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 9E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that i have resd and examined this application and know the same�o be true and <br /> correct All provi�ions of laws and ordinances govermng this type o!work will 6e comp/eted <br /> wnether specified herein or not. The granting of a permd does not presume fo give authoiity to <br /> violate orcancel the provisions olany otherstate orlocallawregu/ating construchon orthe <br /> crmance of onst�ucf�or. Th3t 1 am authorized by the owner of this property to periorm the <br /> �wor vhicb pplication is made and I comply with the State Contractors Law 18.27 RCW anc' <br /> 296.200 AC.' <br /> I C i �. <br /> ,� ��12 Z 1��i <br /> Signawre Date <br /> Eo��o-oqa' <br />