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f <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32G0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FRQM 8 AM TO 4 PM <br /> :�-�`��.'�j � I.Yt� >� . i '_V i' \'Q y� <br /> t � <br /> PROJECT ADDRESS <br /> ���� _1�( \ �\1� ���� \�yZ� � �—��C� — L,���JU <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address Ciry State/Zip Phone <br /> ��`C ���l�l ��.1.,'�1� �L. ��IzS� ZL�Z- ��I� <br /> Eleclrica�Contraclor M11ail Address Cify S;ate/Zip Phone <br /> ��v��c.-��N�=C..G�; � N T <br /> State License Numbcr Contrac!Price of Work <br /> ;���\U.i%V1� \(i-� l '�,iJ - 1��_X <br /> Proposed Use of Duildin� ' Conlact Person (Plan Review) <br /> Description o(Work l0 9c Done: �U1�f � � �-�M.J '� l'� �� C�In�� ��-�— C'�--��'1� `�.-X <br /> 1-- <br /> NOiE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �'= <br /> � I 1 C;� <br /> CITY OF EVERETf"LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRily fhaf 1 fra� iead and exarnined this application and knon�the same fo be true and <br /> correcL All provisions nvs and ordinances got�errun,q this type o��rork will be complefed <br /> whether specdied hen r noL The granting o/a pennd does not resume to give aufhoriry fo <br /> violafe or cancel fhe�ro�isions olany other stafe or local law reguPting consUuclion or fhe <br /> perlormance o(construction. That/arn authonzed by Oie owner o/fhis property to pe,�lomi(he <br /> work lor rvhich applicafion is rnad�and 1 comply wifh the Sfate Contrac(ors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> �/, �i � / � � � � � �. <br /> / �5 nalure ��� Date <br /> ✓ <br /> �� � z -v�3 <br />– - - - _—. <br />