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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S� `a �� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �,�G� g-pp <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� � j C'� 1 C '��l- �s ��Ul- <br /> PROJECT ADDRESS <br /> C� <br /> ' � � <br /> �—� <br /> r; i'1 +n�� � -C"'��i. _ <br /> OWne� A1all Addross Cily SlaleJZip Phone <br /> Tenant Mall Address Clly Slata2lp Phone <br /> ( •,inl <br /> kt� � lh .�nc ��� -`. _K �'i� _ 1^��:i •�' �� Ls� • �N��^ �..;9 �3�I <br /> Eleclrical CoMraCbr Mail Addross Cily Slale/Zip Phone <br /> � IC� 5� �.E �'J C "' �'Z <br /> Stale Uconse Number Coniract Price3 of W:�ik <br /> Proposed Use ol 6uilding Contact Porson (Plan Revinw) <br /> Description ol Work ln L�c Done: 1���' �<-�. +�y '�_C�%� <br /> T— <br /> NOTE: WIRING IN NON-DWELLINGS IS kEQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAE3LE. <br /> C�TY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereAy ceriily(hat 1 have renAenAexnminod fhis applicntion enA know fhe seme fo bo truo end <br /> corroct. All provisions ol laws end ordinances govornmg fhis fype o!work will6c conrplefeC <br /> whe(her specilieA he�ein o�nof. The g�anling o!e pomuf does nof prnsumo fo give eufhonty fo <br /> violnfe or cencel fhe/no��isirnu ol any other stafe o�locnl law rogulafing consfiucfion or fhe <br /> pvAonnnnce o!consfruction Thel I am nuthonzad by fhe ownnr ol fhis property fo peAomi Ihe <br /> wo�k lor which npplicahon is mad�anA I cornpty with the Slofe Confrec(ors Law iB.27 RCW and <br /> 296.200 WAC. <br /> , I <br /> % �' U � _ .,, � <br /> � t� �, '�. ,._� � " c L� � <br /> �Si�nalure � � Date � <br /> ���� <br /> � <br />