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ELECTRICAL PERMIT APPLICATIQN <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 /> ' ��I -i G � 1 . S-� � ��� � <br /> PROJECT ADDRESS I <br /> i . 1 `1 Z l;''�� %,.t-5 1 <br /> � �' �-_ �11 '�\' "'.�..� � �o\=\� � '� .��2 �� 1'u.�. �i..te 4�` �.'\_ <br /> Owner A4ail Address City Sla.eQip Phone <br /> Tenanl Mail Address Ciry Slale2ip Phone <br /> � 1� 1 � ..�v .� A�� A,.�} V �1Af � L I �CI i1'.����� � t �v1v ����1�- .� �tl �-���, �I�� � �Z <br /> Eleclrical Co�llractor htail Address City S�ate/Zlp Phone <br /> 1�`-� 1 1.�.-\'� 1�, � j\; '� ��-7-L' .� <br /> Slalo Ucense Number Conlracl Price of Work <br /> � <br /> � <br /> � , � �r�`� ; `'�4 � � �, •�� ��L� <br /> ��-" �-_ - — <br /> Proposed Use o(Buildiny Conlact Person (Plan Review) <br /> Descnplian of Work lo Ba Done: , '� � �� ���-` `� � ��`'''•�� "� �: ��- �`:�''�'„��'_1 <br /> � <br /> NOTE: WIRING IN '!ON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r �1 <br /> 1 hereby,;ertily that 1 have read nnd exnmined this application and kno�r the sarne fo be true and (i C,��� � vI �"� <br /> correct. All provisions o/lau�s and ordinances govemmg this type ol work will be cornpleted <br /> whe(her spea�ed herein or noL The�rantin�oI a permd does nof resume to give airthonty fo <br /> violate or cancel the provisions oI an}�other stafe orlocol law reguPfing construction or the <br /> pedo�mance o/conslrucfion. Thaf 1 am aufhonzed by the owner o(fhis property fo pedomi the <br /> work lor which applicafion is made and 1 comply wifh the Sfafe Confrt�crors Law 18.27 RCW and <br /> 296.200 WAC. , <br /> �) <br /> `- � � . <br /> '. , _- .. � � `, <br /> Si�naWre Uate <br />