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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �� � 7—aS <br /> 3200 CEDAR STREET, EVERETT, WA 98201 G Q SI/—�13� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT�CREDIT CARDS ARE NOT ACCEPTED <br /> l �I �c (r�_� ��� Sjr:.�„-.� <br /> PROJECT ADDRESS <br /> ���YIAr[i �- e'� ��' c1 I'�el.i �-� .`��l' E-�1'rrft' (��1 �Itf.)ei �S' )T��>nye. <br /> Owner �� Mail Address City State.2ip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> �- �ySit�,�a 34�1� ���" i�'P ` k(°l "��' (i+.[t( 4.��1y- i.iA �-�"'3 �i�-�'74- "4lL <br /> Eleclrical Coniractor Mail ACdress City ` State2lp Phone <br /> i�j �7 <br /> (� C: Sy <:S I �i51 k(Z J/���/ �2 a� � `� <br /> State License Number Conlract Price of Work <br /> .�nv�-� ,(f <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � <br /> Description of Work to Be Done: �'1 �"`F � �+���t�� f� �1'u�! tl- <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 herebvi certify that I have read and axamined this applicafion and know the same to be true and <br /> correct: All provisions o(laws and ordinances goveming this type olwerk�vill be completed <br /> whether specdied herein or not. i he granting o(a permd dces not presume to give authonty to <br /> viclare or cance/fhe provisiens olany ofher state or Iecal law regulating construction or the <br /> peno�mance o/consfruchon. That/arp authonzed by(he owner of this property ro perform the <br /> �verk tcr which applicaticn is made and 1 cemply with 'he State Cuntracfors Law 18.27RCW and <br /> 296.200 WAC. <br /> '� 1 <br /> �- . � � � � <br /> „ <br /> Signamre Date ,�� <br /> I/ �/1 <br /> l/ J/ <br /> ✓ <br />