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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 /> %' "10 i ���{,���.�,�� �1,�."_ <br /> � <br /> PROJECT ADDRESS <br /> j1Y:l•ZS1c� � S�-t .�tc— <br /> Owner Mail Address City State!Zip Phone <br /> Tenanl Mail Address City SlatelZip Phone <br /> �'�1���u� �e.lEcfR��. �7Z-� �(04 St Sc �'l�tom�s� �'�C� ����d7z �G�3� <br /> Electrical Contraclor Mail Address City State�Zip Phone <br /> NC-l�o� � 0 751-'Z ��v�2Z/G9) l a, o00 <br /> Stale License Number Contrect Price of Work <br /> Proposed Use o(Building Contacl Person (Plan Revie�v) <br /> Descriplion o(Work to Be Dane: (��—�v��=— /��' 1 �0�''� r�' `���U� <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 �/:r�{ U_ j jl`7 <br /> � >> i � -t— <br /> 1 hereby ceRily fhat 1 have read and examined fhis applicafion and know fhe same fo be frue and � <br /> conect All provisions ollaws and o�dinances govemmg this type of work�ril1 be complefed <br /> whether speci6ed herein or not The granting of a permit does not resume to give authonty fo <br /> violate or cancel the provisions of any other sfate orlocal law reguPting construcfion or the <br /> peAormance olconstrucfion. That 1 am authorized by fhe owner ol Ihis property to pedorm the <br /> work Ior which applicafion is made and 1 comply wifh the State Contractors La�v 18.27 RCW and <br /> 296200 WAC. <br /> -=-�._.�--,�t�� 14 - ��' -o � <br /> Signaturc Date <br />