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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 ACCEP7ED FROM 8 AM TU 4 PM <br /> /(�� �! -�,�i4D(�tlr¢; .Si�7c 'A' <br /> -! � � �v r� �?���o / <br /> PROJECT ADDRESS <br /> Own3� Atail Address City St31c/Zip Phone <br /> Tenant h.ailAddress City Statc/Zip Phone <br /> ��vN/�'a�/f�'/,GC a�?�l �l/��/�.�tr/�� /z�/rf,�% /�yr.f�0/ ��,�(7S,(s GS� <br /> Electncal Contractor Mai�Address City -�Slate2ip Phone <br /> , ' / � ��oa�°= <br /> , <br /> State License Number Contracl Price o(Work <br /> �� ,/ / <br /> --_l,c;t� �� (/J <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> i � � <br /> Description of Work to Be Done: ��(�/T/�G G pl� ��Q�-� /y�/ �(i{,�°n`�,� f/� , <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 /> I�iereby certi/y fhat I have read and exarnined this application and know fhe same to be true and <br /> correct. All provisrons ollaws and ordinances governmg fhis fype ol work ivill 6e completed <br /> �vhether spea�ed herein or noL The granting ol a pernnt does nof resume to gii-c authoiity to <br /> violafeorcancelthe�rovisionsolanyotherstateorlocallawreguPfingconslructionorthe <br /> pedormance oI construclion. That 1 am aufhonzed by the o�w�er oI lhis property to perlomi the <br /> �vak Ior h applicafion is made and 1 comply wifh the Sfate Contractors La�v f0.27 RCW and <br /> 296.2 A . <br /> � / <br /> �--� 'U / �S <br /> � Date <br /> ��5(h-G� � <br />