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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 G �, (3 .� � <br /> ���,� �� ��c'< <n.� ��•, e• ��'��-c �-� — 1..,�f� � �;, Z c �� <br /> PROJECT ADDRESS <br /> Sc, � a� - � � 1��.��� _ <br /> Owne� Maii Add�ess Cily Slate/Zip Phone <br /> Tenanl Mail Address Ciry SlatelZip Phone <br /> �'�arv�i� lec.�(';L IGIc'1 7�h a��e SE -� Y'� ( �c.mre f-�-, c�'<i `(�' 20�:5 <br /> EledtiCal Contractor Mail Address City State/Zip Phone <br /> l�'� /1 �U� � � � 33LZ `�' D ' <br /> Slate License Numoer � � � Contract Price of Work <br /> !'GN.IA 1 `✓Lt� <br /> Proposed Us of Building Contad Person (Plan Review) <br /> Description of Work to Be Done: �C`�� C\C'L�.-Fi�i I `J � �� �� � /V��U �.� ��a. <br /> I,t ��,� <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 C�DE IS 3105 <br /> 1 here6y ceriily that 1 have read and examined thi;,application and know fhe same fo be frue and <br /> correcf. All provisions o/laws and ordinances govemmg this type o/work will be completed <br /> whether specilied herein ornoL The granting ol a permd dces notp resume to give aulhonty fo <br /> violate or cancel fhe provisions ol any othar state or local law regulating construcfion or the <br /> performance o/construchon. That I am aidhonzed by the owner of lhis property to perlorrr, fhe <br /> work lor which application is made and I comply wifb the State Confraclors Law 1827 RCW and <br /> 296.200 WAC. <br /> ; �. � /z o -� <br /> �7G �� �� <br /> �Sgnn ure Dat <br />