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l/ <br /> / (/�����-/ � <br /> ELECTRICAL PERMIT APPLICATI(J(�f <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE fT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.org �` I' —�/ <br /> yo I � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � p�p7—O �t � <br /> ��(�,t� ,�,c��' ��/ <br /> PROJECT ADDRESS <br /> � � <br /> Owner Mail Address Ciry Statel.'ip Pnone <br /> ��1/��e�/!1_.�__��,L1 ��•'�t-`Z 7 -��L� <br /> r��l.f'I�/�,�. <br /> Tenan� Mail�ddiess it :,lale2ip Phone <br /> C��/=� rr��"TJi � � %�/�-�a� ��"��. �,',�f�_ <br /> EICC�riCal COnt2Cbr Mail Adtlress Cily StaleRip � i hone <br /> (1 �"� � ��/�-/YlU — <br /> State License Number Contrect Price of Work <br /> �'P�//�. ' % - <br /> �roposed Use of Budding Contact Person (Plan Review) <br /> Descnplion of Work to Be Done: ������! ��a-t�! /-�LC��/ �,` � <br /> NOTE. WIRING IN NON-DWELLINGS'S REQUIRED TO FFE <br /> BE IN RACEWAYS, MC OR AC CARLE. <br /> CITY OF EVERETT LOCAL SALE51"AX CODE IS 8105 <br /> 1 hweby certdy fl�at I have road and ezaniined fhis apphcafron and know the samo to oe Irue and <br /> cormcL All pmv�srons ollaws and ordinanctas govemmg Ihis type oI work wi11 bo mmplcfe4 <br /> mhelher specfied herem or nof. The gianfinc�07 a pem�d does nol presume to give au(honty.� <br /> molale or cancol tlro pmvisions ol any ofher sfate or/ceal law regulahng constnic6on or(he <br /> pcdomrance ol cons(ruction. That I am aufhonzed by fhe owner ol(his property!o pedomi fho <br /> wo/k Ior which applicalion is made and!cromply wifh fhe Slale Con(racfors Law 18.27 RCW and <br /> 296.200 NJAC. <br /> /'� -��—� .JcJ��1 // i a –� <br /> Signalure —�ate T <br /> �(�C� � ' `��� <br /> �._ _ __ - <br />