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i <br /> ELECTRICAL 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 B AM TO 4 PM <br /> (o Un '_3 � 3 �� i�� i,J [=�.�,-� �l, 6✓�1 `i 8'�� �� <br /> PROJECT ADDRESS <br /> Owner Mail Address City Slale/Zip Phone <br /> I if <br /> ���i0 JIu� T �''i'lP� �i p�o 3 �3 I�r. G✓. [`�trt� �✓�'Y- `jBZr� <br /> Tenant MailAtldress Cily Slate2ip Phr.ne <br /> .1- .1.�-P�1h0.,�d � �vG' .-lnc . L✓Or'A� n ✓.�l! �Vr}' /C���2 <br /> Elecirir,,l Con ctor Mail Atldress%�� Cily Slale/7ip Phune <br /> / / <br /> .,-..��. l 3 � . � �-��- � � � ,. z�� _ <br /> State License umber ��. - CoNract Price of Work <br /> ��c+'�Z /l3^�� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description o(Work to Be Done�. ��t,� Lo%L..��v� <br /> NOTE: WIRING IN iVON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certily Ihat I have read and examined fbis application and know the same(o be true and �. �i, <br /> coirecG All provisions ollaws and ordinances gove�rong this type ol work will be conrple(ed a�U-\ ��j --U�—, � <br /> whefher specilied herein or noL Tho 9�antin�ol a permd does not resume(o give auUrority lo <br /> violate or cancel the provisions o�any other s�ate or local law regu�fing construction or fhe <br /> peAorrnance ol construc(ion. That I am authorized by the owner ol this property to perfonn the <br /> work lor which applica(ion is made and I cornply wifh the Stafe Confracto�s Lew 18.27 RCW mtd <br /> 296 200 WAC. /J <br /> �i�1�? / /!�t-CF� /v � O j <br /> ��nature ate <br />