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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 /> > ^ �� _ <br /> -{ I C 1-�<, cC,�lli-, __-�_ <br /> PROJECTADDRESS—� <br /> Owner Mail Address City Stala2ip Phone <br /> � il <br /> Tenanl Mail Address City SWle2ip Phone <br /> �� (Z.��.) iLo <br /> � �M�-`��'� 1=[:.L'Z y�l� [o2�Z ,��v ��c-tit�, ��/l,i�;��� G„�4-h�7,;;�� �3�s 3 <br /> [I^clrical Conlraclor Mail Address Cily Stale/Zip Phone <br /> �,� <br /> , � � <br /> JLI�I(:jGdi�,l� � `� � � 1� — � �U� <br /> Slate Licenso Number Coniract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Bo Done: I ��"L� t ���` I L {� �S- L'`�-L�-� <br /> ���5 c•�� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> 1 hcreby certily tha(I have read and examined this applica(ion and know fhe same to be We and <br /> cerrect All provisions o/laws and ordinances govemmg ffus ty��e ol work will be completed <br /> whefher speafied herein or noL The gianting o/a pemut does not pmsurne to give authonty ro <br /> violafe or cancel fhe�rovisions oI any ofher sfate or local law regu/ating construction or fne <br /> performance o(construcfion. That I am aidhorizeo by fho ownero/(his pre;�erty to parfom�fhe <br /> work(or wbich applica(ion is made and I comply with the Sfate Confracfors Law 18.27 RCW and <br /> 296.200 INAC <br /> Signature <br /> Dale ��� �� <br />