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�LECTRICAL pERMIT A@PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, E��ERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �-����i -�� _ r� 1,{/� �-�5� <br /> PROJECT ADDRESS �— <br /> �� � � � I�J��t�'. <br /> � ---- <br /> �-���Q���� «� <br /> Owner � Mail Address City Stale/Zip Phone <br /> � �>,k `u� ��uu� � <br /> Tenant Mail Address Cily State2lp Phone <br /> /�Sl <br /> �c�dt�v� �(��$v��c l��o�i sKs-:�.�1/�=' � I�'u�( u,r¢ yg�3 :9-�-�/�� <br /> Electrical Conlraclor Mail Address City Stale2ip Phone <br /> i� � Gf��(� (�`�S"� � � , :-��, <br /> �GD <br /> Slate License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Work l0 8e Done: �G��l � ��t�� ��tG� �(��""`s <br /> NOTE: W IRING 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 /> I 1 here6y certily fhat 1 have read and examined Ihis appfication and knew the same fo be Wa and <br /> coaect AN provisions o/laws and ordinances goveming this rype o/work will be completed <br /> whefher speci�ed herein or noL The granfing ol a permif does nof presume fo give authonty to <br /> I violate or cancel the provisions ol any other stafe or local law regufatino consfrucfion or the <br /> perlormance of conslnution. Thaf I am aufhonzed 6y fhe ownero/thisp ropeAy fo perform the <br /> work Ior which applica(ion is made and 1 comply wifh the Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��:�/��%' (� r����� `�`� l'" � (.� n �� <br /> ignature :� - Date " <br /> � i �',�`�� � <br /> J <br />