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ELECTRICAL PFRMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 '] . 7't—08 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org C ���_��g <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �)Lu. � � �... I t1 �_i'i �. (_� <br /> PROJECT ADDRESS <br /> I�� C�>, ' �_ i � �.' i <br /> OYmer Mail Address C�ry Slate2ip Phone <br /> Tenen� Mail�dd�ess Ci�y StalelLp Phone <br /> �-� - i r �� � s N II- -� \ n l.rll� ��, '�_l1�bL'.,�-' <br /> 1 l � � <br /> Electncal Contracta Mail�dAress Cily SIa�e2ip Plione <br /> `' i - <br /> ��-�: � (1 �.��._'.. .li�,. 1, �_ ' ._.L�' _ <br /> State License Number Contrect Price ol Work <br /> Proposed Use ol Bwlding Contact Person (Plan Review) <br /> DescnDhonofWorktoBeUone �� " --���. �-� _ ' ' �' � _''_' �-�_�� "„ _ L',.�: ��- <br /> —:Tt_� � ( I' . _-i�, t — <br /> NOTE WIRING IN NON-DWELLINGS IS REOUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE � <br /> ' ��_ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br /> 1 hr,�e6y certdy tliaf I have read and examined fhis app6ca(ion and know fhe same fo be fn�e arrd <br /> correcf All provisrons ol laws anA o�drnances governnrg fh�s type ol work will be completed <br /> whether specibed herein or nof Tho granhng o!a permd Aoes nnfPresume to give aufhonty fo <br /> viMafe nr cancel the provisions o!any othe�s(a!e or local law iegwahng construchon or the <br /> perlormance ol conshueGon Thaf I am nuthonleAby fhe owner o(this property fo parlorm fhe <br /> work loi which npp6cahon is made anA 1 compty wrth the Stafe Cnnfractors Law 18 27 RCW and <br /> 296 200 WAC. <br /> i ` <br /> - ! -1 j .:I �' '� � � <br /> �gneture Dale �-�� � ��ri � <br /> I <br />