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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 /> PROJECT ADDRESS - <br /> `� - ��-' 7'� <br /> - C' <br /> , • <br /> � ' , �� ' �� ;-- / ./ i ' <br /> :. i.c:�.J �� l , �1��..�- C_. L. �. � / tir.�/ �...., ; :_I' `�, ! ";. ; /,�/�' /— i/! ��,.,; <br /> wner Mail Addross Clly Stale2ip Phone <br /> Tenanl M�il Address Clly Stale2ip Phonc <br /> C���.1�,fC,��.`�L_ <br /> Electrical Contrector Mail Address City State2ip Phone <br /> Stale License Number Contract Price of Work <br /> /�;'i[J)(, <br /> Proposed Uso of Buildinu Conlacl Person (Plan Re✓iew) <br /> DescriplionofWorkto �eDone: `?r "� \�'L�-J //�/]i��� l�� �/�/�5�, `' <br /> _. ` <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 ccrtiry that 1 have read and exemined fhis application and know Ihe same fo be true and <br /> correct. All pro���sions of laws and ordinances govemmg this type ol work will be completed <br /> whefher spec�Led herein or noL The granting o(a pemut does not prasume fo give aufhonty to <br /> �-iola(e or cancel the provisions ol an}�othe�sfate or local latv regu/afing consWchon or the <br /> peAomiance o/construction. That 1 arn aufhonzed by the onner o/tbis property to peAemi the — �—� �f � <br /> work lor which applicafion is ma�e and 1 comply wilh fhe Sfnte Confracfors Law 18.27 RCW and `U � � � <br /> 296.200 WAC. � <br /> �� '� /. /` l � �J �(� C� / � <br /> _•—��i: _ � / ��(� <br /> � Signature ! Da6 <br /> l <br />