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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �+ <br /> 3200 CEDF.R STREET, EVERETT, WA 98201 �� �`� / <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org �QgQl--f)7�" <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �(1')0 c��'d � � L.._) <br /> PRO:ECT ADDRESS <br /> �, -. �_( ;�� `-I �+r � �, �04(k� ���'d ,��r �,J �1l�.r��_ GJ� �j ��Z, <br /> OWuer Mail Address Ciry State2ip Phone <br /> Tenanl Mail Address Cily . Stale2ip Phone <br /> �t�� �I f G�% IC_ �`l � �i L.�iG �. I/��! !f"VC� �'IJ{'� <J � ��Gf(l .�Zo13 cLu3 <br /> Electrical Contraclor Mail Address Cily Stale/Zip Phone <br /> /-�����-�__ lG� Cj(,�,� (��_ `���j�'1 IL <br /> State License Number Contract Price o(Work <br /> Proposed Use of 8uilding Conlacl Person (Plan Review) <br /> � <br /> Descriptio,i ot Work to Be Done: ✓ <br /> � "— C Ul r <br /> j����c��� E���,,c� d '-ans (' tMov �� 1�����s arv-w.t�l <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily(haf 1 have read and examined Ihis applicafior�and know the same fo 6e true and <br /> correct All piavisions of laws and ordinances goveming this type o/work will 6e completed <br /> wheth�r speafiad herein or noL The granling ot a permd does not presume fo give authonty to <br /> violafe or cance/fhe arovisions ol any other state or local law regulating construction or the <br /> performance o/constnicfion. Thet 1 am authonzed by the owner o/fhis property to peAorm the <br /> work lor which applicafion is ntade and 1 comply�vith the State Contracfors Law 18.27 RCW and <br /> 296.200 W�� _ <br /> � � ,� � <br /> � % �� ' / - /�'- G ,�- <br /> ure__ __ -'��\ Oale �D/_ �� <br /> ,\ <br />