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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 5�201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T�4 PM - DEBIT 8 CREDIT G1RDS ARE NOT ACCEPTED <br /> �t��7 -�,.. �� �d��, <br /> PROJECT ADDRESS � <br /> l/; /h / (�Y�/j P`lr �yL+�ly�� l 'U/� iJ�J��I � P.'r �T �/Jf %� r�U / OS /� 1��7 <br /> Owner Mail Address Ciy State2ip Phone <br /> Tenanl Mall Address Cily State2lp Phone <br /> � <br /> j�-_•�tvsl �c.y� / .f'/�c �i-•i 1,,� <br /> Electrical ContraCtor Mail Address City StateZp Phone <br /> ��O(� �. <br /> State License Number Contract Price ot Work <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description of Work to Be Done: ��c�c� /� _�._ �, /-, / � �c / � � �T <br /> s <br /> , , � <br /> �., �� 1 /�c f� �L.�/�'� <br /> NOTE: WIRING IN NON-DWELLINGS 13 REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y c=rti)y fhat I bave read and examined this application and know the same to be true and <br /> , comect. Al/provisions o7�aws znd o�ainances governmg this type of work will be complefed <br /> whether speci�ed herein or Rot. The granfing of a permrt does not presume to give author.ty to <br /> vioidfe or cance/the provisions ol any other sfate or local/aw regulating consWction or the <br /> performance ol construchon. That/am authonzed by the owner of th�s property to perfonn the <br /> work lor which application is made and I comply wifh the Sfate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> C Ifl, -� �Y�%�v ��� J _s ��>J� — �(r�����/� <br /> Sigrature Date �'V / <br />