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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR.EET, EVERETT, WA 98201 � _�� _�� <br /> 425-257-8810 - FAX 425-257-8857 —www�.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C G �C 7�U�''� <br /> ; g � � cv � s3 � <br /> PROJECT ADDRESS <br /> fl� � �`� Tv��� <br /> � , �-/� �- z 3�- rS� Y <br /> l,� M � ;��P�� <br /> OwnBf Mail Address City Slate/Zip Phone <br /> Tenant Mail Address Cily Slale2ip Phone <br /> � �i'212' � I�O <br /> 1 � u �� i J �M i�� c ��n ,� � � Y � � (� �tis,� c,� <br /> Flec�ncal Contraclor Mail Address City Slate/Zip L Phone <br /> Y,��N. <br /> �,JJ-� O�-,=�� z � ��� .? . �� � <br /> Stale Licensa Number Contra t Price of Work <br /> `�- �J� <br /> � <br /> Proposed Use of Building Contact Person (Plan Review) <br />, Description o(Work to Be Done: ��� � �kt� � J-� �✓�'� /' J I✓Z ✓I �..= � <br /> �"� l S L �,=. c.,� . R,- <br /> NOTE: W IRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi/y fhat I have reaA and examined Ihis applicafion and know the same to be tnie and ��''�U � - � �2 �� <br /> correcL All p�ovisions ollaws and ordinances c�overmng fhis type o/n�oik�rill Ge completed ' <br /> whether specilied herein or noL The granting ol a pennA does no! resume fo give aufhonty to . <br /> vio/ale or cancel(he provisions ol ar;y ofher slate or local law re,quPfinc�construchon or the <br /> pe�lomiance o/constmction. Riaf!am aufhorizeA by(he owner o)fhis property fo peAomi the <br /> wo�ic Ior whicl ppiic lion is mado and 1 comply with the Sfafe Contractors Law 18.27 RCW and <br /> zss.zoo wg . � <br /> ' ' � � <br /> , I <br /> `J <br /> SI �Uro � Dalo ' ' <br /> 1 � <br /> � <br />