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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER�'ICES <br /> 3200 CEDAR STREET, EVER[TT, WA 98201 <br /> 425-257-8810 - FAX 425-257-3857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I`J�jC� �-U e(' Ce� ��tit <br /> �1� � � <br /> PROJECT ADDRESS <br /> i�� u��U�� �F ���� <br /> Owner Mail Address City Stale/Zip Phone <br /> �I pUr�'� �i1��xC�� v.r'��/ �lJ�'2.�7— l^'1 � �J-�/Z�l- �3Z,� <br /> t3 <br /> Tenanl Mail Address City Stale2ip Phone <br /> M�, s ��� �������S,i� 21,�2� �-l„-y5'�( �,�� �'��outi/ VUu<,�� �-'� 9£�273 3�� yzy-�7s <br /> Eleclrical CoNraclor Mail A� ess Cily Slale/Zip Phone <br /> v� <br /> I�I� �y.-�rSCvL�C� ��-o <br /> Slate License Nwnber Contract Price of Wqrk <br /> � . Q,�i I Cv�� ', <br /> C�� � r w�e.r- <br /> Proposed Use of Buildiny • Contacl Person (Plan Review) <br /> Descriplion of Work la Be Done: I�^`��`���� � �'���'� s���� <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 here6y cerli/y iha,f 1 have read and examined Ihis application and kno�v the same to be true and <br /> correct All provisions of la�vs and ordinances goveming fhis type ol work will be complefed <br /> whether specilied herein or noL The granting o(a pernuf does not presume to give authonty to <br /> violate or cancel the provisions of any ofher state or local la�v regulating construction or the <br /> performance oI construcbon. That I am authorized by the owner of this property to pedorm lhe <br /> work(or which application is made and 1 compty wilh Ihe Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� ' �.- I.��6 - <br /> Signature Dale <br /> �G��$-r�a� <br />