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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE� <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 /> �: � �> � � ��C�"{� �C�n 4'bv� �l Q�F� <br /> PROJECT ADDRESS <br /> �f�f' ��'1cCc, �) �g�`j C���sf 6�N' �'��N ►av� ���t-e`���1� �BZo� S(�2�-7Go 3 <br /> Otvner Mail Address Cit <br /> Y Stale2ip Phone <br /> Tenanl Mail Address City Statc/Zip Phone <br /> �C'c�s�t� ���c�'r�c. -�� ��.s—�}YO �G�e�,� � � �1Py�-o(n �1 s-�3`1-a39'I <br /> Electrical Conlractor Mail Address City State/Zip Phone <br /> �N '`JS�f�...L.. �53�� <br /> State License Number Coniract Price o(Work <br /> 'Il'E�l4C��°N\,Qi /�'tW �GSS�/`, <br /> Proposed Use of Building Conlacl Person (Plan Revie�v) <br /> , �Description ot Work lo Be Done: �� ,p�aC r� ��A `7 p�^ �i�� Gn.� <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�S 3105 <br /> I hereby cerii/y(hat I have read and examined fhis application and know(he same to be frue and <br /> cor�ecL All piovisions o/la�vs and ordinances govemmg fhis type o(�vork tvill be completed �C��, -i�c-, <br /> whe(her spcuGed heprein or noL The c�ranfing o/a pennd does not presurne to give auflronty fo <br /> pe�rfo�n i ce�olco'rutruclion��That I am a�uffiorized by tl e/oivne9o%this property tto pe�rrm(he <br /> �vork lor whid�appiicafion is niade and 1 comply wi(h the Sfate ConVactors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �� � <br /> ` �_`� _o�_ <br /> ic�naf rc Dafe <br />