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ELECTRICAL PERMIT APPLICATI4N <br /> CITY OF EVERETT PERMIT SERVICES �o��_oo l <br /> 3200 CEDAR STREET, EVERETT, WA 98201 W� <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org �� `a ��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �>� 5 I — ,� r=� 4 � W �# Y , F�!° f t_T��-, '"rt:�c :. <br /> PROJECT ADDRESS <br /> �-' �. :i- Lv . 1 ��.. or� �,.�w, e_ <br /> Owner I,�ailAddross Clty Stale/Zip Phone <br /> 'i �-, Nn r <br /> Tenant Mail Address Cily Slafe/Zip Phone <br /> / <br /> - - ( u�n-v1� <br /> Electrical Conlractor Mail Address City Slate/Zip Phone <br /> Sfalo Ucense Number Contract Price of Work <br /> Proposed Uso of Building Cor,tacl Person (Plan Roview) <br /> Description of Work l0 8o Dono: ; Qli� Od(.-� !�/ � h ��/ / / _� <br /> i� <br /> f-C Ai <br /> tJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriily that 1 hav�read ond exemined this applic�tion and know fhe samo fo bo Wo and <br /> correct. All provisions olla�vs and oMinances govenung(h!s type ol work will bo complefe�i <br /> whe(her speafied herein or nof. The granfing o/a perrmt does nof presume fo gi��e authonty to <br /> violafe or cancel the provis(ons ol any ofher sfafe or local law regulating construcfien or the <br /> perfomianco o/construcLon. That 1 am aathorized by fhe o�vner ol th�s property tu perfomi the <br /> ��rork Ior which application is mado and I compty wifh the Slato Contractors Latv 18.27 RCW and _ ('�I <br /> 296.200 WAC. O I r <br /> �Jo��l ��' � I�-�� ,, �, �� �� I <br /> Sianature Date ' <br />