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ELECTRICAL PERMIT APPLiCATION <br /> CITY OF EVERETT PE�MIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,. �� � � �� C� / �� 1/ <br /> pROJECT ADDRESS i <br /> r <br /> � 'vCv�� � �if9 � c �. <br /> Owner Mail Address Ciry Slatc.'Zip Phone <br /> � ��'-' /l%�v �f5�� ���/Ci <br /> � Tenanl <br /> Mail Address C�ly Slate2ip Phone <br /> n � ' � 2c� � g4 - SSy / <br /> I"j P c , �1 �iP � �:.-r1 L L � c v 1 e <br /> Eleclrical CoNrector <br /> Mail Address Cily Stale/Zip Phone <br /> 1 <br /> / I L �����/`'��� �3 D 0 s u <br /> I� � � ` I� L `' � N �' l L Conlracl Price of Work <br /> State License Number <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> L'escriplion of Work tu Be Done: ,��1'1 r ^ � / � ��� � �� � ��� � r i � � �� v� L <br /> i � vi�r + � <br /> NOTF: WIRING !N NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herauy cerfily fhat 1 have mad t�nd examined fhis applicalion and know Oie same to be true and <br /> cormcL All provisions ol laws and ordinances govemuig Ihis fype o(work�sill be compleled <br /> whether specilieJ heicin or noL The granfin�al a permd does not reswne fo�ive aufhonty lo <br /> vio/afe or cancel fhe provisions oI any ofher stafe orlocal la�v reguPfing construction or the <br /> peAomiance o(consfruchon. That I am aufhorized by the owner o/fhis property to pedam fhe <br /> wo�k for which application is nmde and�ompty wifh fhe Sfate Confractors Law 18.27 RC W and <br /> 296.200 WAC. % <br /> ���� �'�r�i;,', <br /> SlgnaWre Date ' In i� � <br /> � <br /> � � �. <br /> %� J <br />