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ELECT'�ICAL PERMIT AP^LICA,TION <br /> CITY OF E:VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - '=AX 425-257-8857 —www.everettwa.org <br /> Z_a��ag <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L�gQ2�16 <br /> �� � 7 �i�OL,11/J �� / � �_� <br /> PROJECT ADDRESS <br /> j" � <br /> , .'�J �--,�� S� �;�'���� I'�✓. � ��� �r�',,{r( <br /> , <br /> Owner � Mail Address Cily State2ip Phone <br /> Tenant Mail Address Ciry StatelZip Phone <br /> Electrical Conlraclor Mail Address Ciry State/Zip Phoro: <br /> Slate License Number Conlract Price of Work <br /> Proposed Csc ot Building Conlact Person (Plan Review) <br /> Description o(Work lo Be Done: � a��� i�� � �liiJ C"!•i."� �`f"�l K°r'�/,� ��� <br /> ' / -' <br /> �7 //���- / /�l/-/.Lf� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE_ IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF E'JERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceKi/y fhaf 1 have read and examined this application and knon�fhe sarne fo be Vue and <br /> correcf. All provisions of laws and o�dinances governmg this fype o/u•ork will be complefed <br /> �vhefher sp�.a(ied herein ornot The granting ol a permd does not resume to give authonty to <br /> viofafe or cancel tbe�rovisions ol any other state orlocallaw reguPting construction or the <br /> peAomiance ol construcfion. That 1 am authodzed by the owner o(this property to perlorm the <br /> work!or wl�ich applicafion is made and 1 compty with the Stafe Contracfors La�v 18.27 RCW and <br /> 296.200 W,4C. <br /> �"I / ,(� <br /> �' �/���2� l�� T �.�'� �CI <br /> i�. <br /> Siynature Date <br /> ��� _ ,(r.:� <br /> L� <br /> � <br />