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��- � <br /> 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 A AM TO 4 PM <br /> ' / , ,�, /' i'i <br /> �7 ,%'� �1�"�: ,_!�','.i � <br /> PROJECT ADDRESS <br /> � � ��-- � �f ��J ';' ,� - _ �� 1�� ���� i- �* ) ���"- . <br /> Owner � Mail Address City � Slate/Zip Phone <br /> q2� 2J0 3�J2_ 5 <br /> Tenanl Mail Address City Stale/Zip Phone <br /> � � . . I � . 1 .� . • . � / � � /� ��/ <br /> 1-: i� .. - __ . �(] �(� <br /> Eleclrical Conirac�or htail Address Cily Slate2ip Phone <br /> . , ✓ / . , ' � /'I i 1 - /. �� "�(��'_ _ �'i .�r i' i::� .. .. <br /> � �_ <br /> Slate License Number Contracl Price of Work <br /> ; .. � . l�h:�'/��c�� r �7� �����J <br /> Propused Use ol8uilding ` ��G J� � Contacl Person (Plan Review) <br /> � � � �� <br /> Doscription of Work lo Be Done: ��.: � `� � '-. � �� ' �:�':J <br /> _ . � � � � 'r. � I.- <br /> ' 1 ' �•- � — �� � <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 certily Ihat 1 have read and examined Ihis epplication and kno�v the same to bo lrue and <br /> r.orrect. All pruvisions ollaws and ordinances�oveming(his type ol work will be completed <br /> whe(her specdied herein or noL The granting ol�permrt does nof resume to give aufhonty to <br /> violate or cancel(he provisions ol any ofher sfate or local law re�uPtinr�construction er the <br /> per/ormance ol construcfion. That 1 am authonzed by fhe owner o/fhis property to pedam the � <br /> �vork!or�vhich applicafion is made and I comply wifh the State Confractors Law 18.27 RCW nd <br /> 296.200 WAC. � <br /> _ � _ '' . � : ,J 0. �'I '2� <br /> . �.` l _•i•", '�, • J' I � V <br /> Si�3naWre � ate / / <br /> ` ' V <br />