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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREEI', EVERETT, WA 98201 5_ � � _�� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCI:PTED FROM 8 AM TG 4 PM �r����ob <br /> i ", � <br /> I? � „ �; <br /> ' - i� ,)�,r ..� {1�� �_�' "� <br /> PROJECT ADDRESS J <br /> ' � � c ���� <br /> � <br /> I � ,7-� `� �� � �'S � <br /> Owner Mail Address Ciry SfztelZfp Phone <br /> i enant Mail Address City State/Zip Phone <br /> �Db 7SS n07U <br /> 1 � (�(7 � <br /> -�/ T�I�� � � rC1� c �i ,��- `�l�r �'�Q l.(.�4iY �y1�1�7an,i'G -� �c��� ��; � 7 <br /> Electrical Contractor Mail Addr�s Cil;� �J State/Z�p Phone <br /> �.�l�� � �1 �. �. �.. ,% � > ti Z I " V �� <br /> State Licens,Number Conlract Price of Work <br /> Proposed Use of Building Contact Person (Pian Review) <br /> �^ <br /> Description of Work to Be Done: ���f-�����-�� � � �� %�� ��r" �� '' <br /> NOTE: W IRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 I7�( <br /> 1 hereby certi/y that 1 have read and examined fhis application and know the same to be true and � �l�/J � �L�� <br /> correct. AI!provisions o/laws and ordinances governing this type of work will be completed <br /> whether spacified hsrein or not. The granting of a permit does not presume to give authonty to <br /> violafe cr cancel the provisions of any other sfate or local law regulating construction or fhe <br /> peAormance ol consiruchon. That 1 am aofhonzed by the owner of this property to perform the <br /> work/or which application is made and I comply wifh the State Contractors Law 18.27 RCW end <br /> 296.200 WAC. � <br /> �✓� ' `� � `) - // <br /> Signature �— <br /> � <br />