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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR �TREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —vrrvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ,�d �� . <br /> . C-as,�ro � . Eve�c-��i <br /> OJECT ADDRESS <br /> �w��/_��� Moil ACCrass Cily 5latelZip Phone <br /> ZY�- <br /> �tJ'�'FJa'Q,DS�� Q�PCL- FSTP�TC ' 2525 w , _ SIfJI� <br /> �ep� Mail AdEress Cily SlatelZiO Phone <br /> -��j�.�c F�.�Y�.i C� \3301 SE, �'' S i ��v.K.�uk, wH `� <br /> ElectriCa'Contracto• Mail Address Clly SlatelAp Phone <br /> � <br /> �2tM�ET �3�1�3T ��L�� <br /> State Licensa Number Contrect Pnce of Work <br /> Proposad Use of Building Canlact Person (Plan Review) <br /> Oescriplian of Work ta Be Done: ��j���- f-LJV A J��v��-� + � ����-� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE4UIRED TO FEE <br /> BE IN RACEWAYS. MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> 1 hereby certily that 1 have read and exammed!his application an0 know the same to 6e true and <br /> cr.rrecL A!I rov�sions ollaws and ordinances povemrnq this type ol work wdl be comoleted <br /> wneMer ec tl herein or not. The grannny �l a oermd tloes not nresume to,qive aothonty to <br /> vio�at r canc I the p�ovis�ons ol any o�har ;tat�+ �r rocal law regulahng constiuction or the <br /> peA ance o constructioryryry���'hat 1 am author:oC Ay the owner o/tNs property fa peAortn the <br /> wo lor whic applicaho as rtlade and 1 comp�y wrth the Sfate Contracrors Law 18.27 RCW end I <br /> 29 .200 WA . I`I <br /> � � � � ��, 1� <br /> �� . �,� ; ;, r� <br /> —Slqnature �° � ��i <br /> �`� ���� <br /> � <br />