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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I f6� � Z <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org / <br /> � �201 'Oa?� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � � �- /��ll� ��� <br /> PROJECT ADDRESS n�� <br /> .-}I- / ' "� i3oS (3a��P � f�tv� �/e�� � 7 0-9/ S <br /> 2���1 I �JI tie - <br /> Ownef Mail Addrass City Stale2lp Phone <br /> Tenanl Mall Address City Stale/Zip Phone <br /> �w� � � <br /> Electrical COnlraclor Mall Address Clty Stale/Zip Phone <br /> Slate License Number Contracl Pnce of Work <br /> Proposed Use oi Building Conlacl Person (Plan Ravfew) <br /> i / <br /> Descriptian of Work lo Do Done: k � � �/C f/ CC a N[— I <br /> (I�i� � +�-� " ���.� � r�t��b�se� <br /> NO�E: WIRING IN NON-DW ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS 3105 ��-Z W _��Zv <br /> 1 heioby certily lhat 1 hnve reod and exeiminod O�is applicofion end know the same fo be true and <br /> conocf. All provlsions o!laws end ordinances yovoming thls type o/work wlll be complefe�l <br /> whefher spea6od herein or noL Tho granting of e pomut does nof presume to glve aufhonty fo <br /> vlolafo or cancel tlie provisions ol any ofher stato or local law reguleting construcNon ar the <br /> perfomiance o/construction. Thel l am aufhorized by the ownei o/fltls property fo peAorm fhe <br /> work lo�whicb applicnfion Is mado and I comply with the Steto Confrecfors Lew 18.27 RC W and <br /> 296.200 WAC. <br /> �-,_-_ _= /- �-/z <br /> Slgna�ure DBVi <br />