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ELECTRICAL PERMIT APPLICATION <br /> CITY OF E1/ERETT PERMIT SERVICES <br /> 3200 CEfiAR 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 - DEBIT &CREDIT CARDS ARE NOT ACCEPTED <br /> —L,`��� �i7oA r�U /�� <br /> PR0.IECT ADDRESS <br /> /- i �� <br /> �t��t=������ I��Z`� ��'c���,�v✓/-��/ �_�rc�`�" ��� Cj�'� <br /> Owner Mail Address Ciry SWte/Zip Phone <br /> Tenant Mail Address City State2ip Phono <br /> (7,_ ,^ 1.- ���.�—������C, ���i� zo l' ` ��T`�.l) �yn�vavrC'� �� I��U� <br /> EleCtrical Contractor Mail Address City Slale/Zip Phone <br /> I;r; �� li=/� � �'(� Ir� /� 75� <br /> State License tJumber Conlrac Price of Work <br /> / �� <br /> V/, � . �� r�:-I I(1���� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �-- �/� / <br />, Description ot Work to Be D�on-e�: ��T1�V� �" `���� l'-t��`�r���/��„j—�_ <br /> ��l�V I�� C /!l/� )�- �`_�') ��,, � � t )i - � I ���>I n)t' ' � / (' � <br /> �'-1 �� l:� ` Ji��j=-��1'� ���il����—� �1-1� l �IV�jf }/ <br /> r <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � r— <br /> �� �� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRily that I have read and examined(his application and knoiv the sarne to be true and <br /> correct. A/l provisions ollaws and ordinances goveming:his type oI work will6e completed <br /> whether specihed herein or noL The granting o/a permd does not presume to give aufhonty to <br /> violate or cancel the provisions o(any ofher state or local la�v regu/ating construction or fhe <br /> pedomiance o/construchon. Thar 1 am authonzed by the owner o/this propeRy fo pedorm the <br /> work/or which appli ation is madk apd I cumply with fhe State Controcfors Law ]8.27 RCW and <br /> 29G.200 WAC. � / <br /> � <br /> -) ;� ,='7 � �� ,,/ - <br /> �� X���['�--/�'�iv 3 2�, c��, <br /> ignh re p e <br /> F_050 3-l�3 <br />