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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 ACCEPTED FROM 8 AM TO 4 PM <br /> J�3� �����25�,� <br /> PROJECT ADDRESS <br /> /' c o <br /> C��F�U L� �! !U �d�Cf j �.J C � C� <br /> Owner Mail Address Cily Slale2lp Phone <br /> Tenant Mail Address City State/Zip Phone <br /> �r��a�1 �1�c a��? fc�y-�,���SE ��e�`f� I.�.�49�� 33c� -��BS <br /> Eleclhc�l Contractor Mall Address City SWte21p Phone <br /> °�/ 3�3 <br /> cJ,�.'�c".F / c � <br /> Slate License Nuniber Contracl Price of Work <br /> 7 <br /> .S F�� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> /' �'' �,( d � o c <br /> Descriplion at Work to Be Done: ������ `/� G�.1 r ( S `� !h-�=v � �( �2 C v ! 5 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CP.BLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 <br /> I hereby certi/y thaf I have rend nnd oxemined fhis epplication end know the same fo be frue and <br /> coirec(. All provisions ollaws and ordinunces goveming fhis type ol work will be completed <br /> whefher specified herein or noL Tho granfing ol a peimR does not prosume fo give aufhonty fo <br /> violate or cancel tho rovisions ol eny ofher sfefe or local law regu/afing consfruction or fhe <br /> peAonnance ol consPrucfion. Thet I am aufhonzed by fhe owner o/fhis property to perlorm fhe <br /> wark lor which applicalion!s made and I comply wilh tho State Confrectors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��'�] � /��774�' � �—� �� <br /> Sipnature Date <br /> ��(73 11'] <br />