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ELECTRICAL PERMIT APPLICAT'ION <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 � l S -0b <br /> ��1�1 �/ ilf�j/ / �Z-t: <br /> PROJECT ADDRESS <br /> ��/.ur.� -S�%1�,;,, 37`,.�-f.�'�y f., ��,^; ,t l�, i�„z--i <br /> Owner Mail Address � City State/Zip Phone <br /> Tenanl Mail Address City Slate/Zip Phone <br /> JC 1�...vc�C� ��•�« �"�''�n `iG� � C�f '7�:':�'; 1��- i�C.)� .�C2� �lJr.� G� <br /> ElecUicai Conlraclor Mail Address Ciry State/Zip Phone <br /> / " ��it'/}N'c-I o 77�tc/ ����, •�l <br /> State License Number Conlract Price o(Work <br /> -*� <br /> ��r7��.�-:,. <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Description o(Work to Be Done: „p`l�c= �%` %"'- ���s= IUr,C�,��� <br /> ,'j �/G�"�G� <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 /> I here6y ceriily that 1 have read and examined fhis applicafion and know the same to be Irue and <br /> conecL All provisions olla�vs and ordinances c�ovemmg this type ol work will be completed <br /> whether specdied herein or not The granting ol a permd does not presume to give aufhonty to <br /> violafe or cancel fhe provisions ol any other slafe or/ocal la�v regu/ating construction er the l�\ <br /> perlonnance o/consfruction. That 1 am aulhonzed by fhe owner of this property to perform the \� <br /> uoik lor�vhich application is made and 1 cornply with fhe State Confracfors Law 7827 RCW and _ ^ <br /> 296.200�..' / / \1� <br /> • � ./! --�: `/�v <br /> -. :�, �/S/� <br /> Signaturc Date <br />