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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT 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 /> JO(= �3 �G G'irC�r,'<>�-':� G�/�/ .10, <br /> PROJECT ADDRESS <br /> �i G �i� Tn�.�� <br /> Qwner Mail Address City Slate/TJp Phone <br /> Tenant Mail Address City SWle2ip Phorre <br /> � c� % C/� �'C il i�i�.'r C /� �. k�a 2 //�}' � �Nr�l c �•.-) lt/�J�// %fl'�� <br /> Electrical Conlractor Mait Atldress � CI� �tale/"p Phone <br /> � �i ! i x_� ,�t/ tt- � �� �. <br /> State License Number Coniract Price of 1Nork <br /> /1 C i l� IJi'/�!ii�/r' <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description o(Work to Ba Done: I�. ( l� , Ti'�/���'�% (�/r"'f �i1'�'`� <br /> �' l�i�,✓�<3 .S� �.��� r iy j�� /�"J �N/� /�F�L/+/i� R ��/� t�/iSi C'i F/�r�.'l� <br /> NOTE: WIRING IN 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 hereby certily that 1 have read and exflmined fhis application and know the same to be true end ECCLII��Z�P <br /> correct. All provisions ollaws and ordinances goveming fhls type ol work will be completed <br /> whether specifiod herein or noL The granting o/a pernut does nof presume fo give authority fo <br /> violnfe or cancel the�rovisions ol any ofher stafe or local law regulating conshucfion or fhe <br /> perlormance o/consfruction. Thaf 1 ain aufhonZed by the owner o/thrs property to pedorm fhe <br /> �voik lor which application is �ede and 1 comply wifh the Sfate Contrac(ors Law 18.27 RCW and <br /> 296.200 W9E. <br /> /� % <br /> ' � / <br /> -�.��� � ���- r.-. '�1 ��e� ��'C <br /> `��Sgnature Date <br /> ,/ <br />