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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 5 � 7= O 7 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org <br /> C- a�o s�oy/ <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> ✓ I /'1 U'� - � U • � � � <br /> '�' •',.� �� rvi:�r'�C u � S � ,�C' 7 <br /> PROJECT ADDRESS <br /> _LL� ���- ��G'��l,�C-L �������:�u-s,-�i��Iyv'(, ,��'t'�L.� ��A , �� ���-Q3 <br /> Owner 1.1ai1 Address City Slate/Zip Phone <br /> Tenanl �tail Addtess Cip� State/Zip Phone <br /> [leClriCal CoMfaClor Atail Addicss Ciq� State2ip Phone <br /> Sta�e License Number Conlracl Price of Work <br /> Proposed Uso oi Buildin� Conlacl Person (Plan Review) <br /> Oescriplion of Work lo Oc Done: <br /> NOT E: WIRING IN NON-DW ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhaf 1 have reod and examined this application and know the same to be true and <br /> correct All pruvisions o/laws and ordinances govemmg fhis type ol�rork will be completed <br /> whether speafied herein or noL rhe granting oI a penmf does nof resumo fo give au0ionty to ��j-1 0'� —p�-� 1 <br /> violafe or cancel fhe provisions of any ofher sfate orlocalla�r reguPting consWcfion or fhe <br /> pedomiance o/construction. That 1 am euthonzed by fhe otvner oRhis property to perfortn fhe <br /> work/or which applicafion is mado and 1 comply with the Stafe Conhactors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> _ � <br /> ._ r � . � '� 7 <br /> Signature Date ' ' <br /> l <br />