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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> _ r". i ��� <br /> --� � ,d:r y!l,��i! l�- <br /> PROJECT ADDRESS <br /> j" � �/� �,� �/��/ /�- /I ; <br /> L7/-a;-i�)f{ �� I�'/.-�� �7�1!rrt/�vlif\ I :7 Vf�� / � l�l /�� <br /> Ownef � Mail Address City Slate/Zip Phone <br /> Tenant Mail Address City Stale2lp Phone <br /> �_ ✓ � <br /> 1 ��� -G' ��i,�c.`r��iG 7�i� ZUI�` ����� �i�v�vUt,�o��r� ��� �/��tJ ��� '1Z� �%�C, � <br /> Electrical Contraclor Mail Address City Slate2ip Phone <br /> �i i�_�•"'1 C�yk Gi�� ��-00 � <br /> State License Number Contract Pnce oi Work <br /> r'�'ll(�y�����'�'l� <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> �-- <br /> r \/ <br /> ���1�'����t� ��� � �� � � <br /> Descriplion of Work to Be Done: r l G l`��r ��Lrt <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 /> 1 hereby certily that 1 have read and examined fhis application and know the same to be true and <br /> correct. Al/provisions of/aws and ordinances goveming this type o/work will be completed <br /> whether specified herein or not The granting ol a permif does nof presume to give authonty to <br /> violate or cancel fhe provisions of any other sfate or local law regu/afing consfrucfion or fhe <br /> perfunnance of construchon. That 1 am authonzed by the owner o/this property lo peAorm the <br /> work�or which application is made and I compty with fhe Sfate Contractors Law 08.27 RCW and <br /> 296.200 WAC. <br /> i <br /> /�/ � , / ` /n i <br /> � / <br /> � 'i �'� � �'�"��"" ,�� � � � � <br /> 'Si9na���e Dale � <br /> 1— �SV'1��� <br />