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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> r!-�C % E//�i r k/� <br /> PROJECT ADDRESS <br /> ����.v,J /��.La.J //��7 3 � �'� D,2 SC�v��z�.�rGr/,� 9� z�sy <br /> Owner Mall Address City Slale2ip Phone <br /> �/Pd� ,��lr+l7.� ��Y/S <br /> Tenanl Mail Address Cily Stale/Zip Phone <br /> C%,�,� ��z��.J ��.,�� <br /> C-ledrical Conlraclor �tuil Address Cily State�Zip Phone <br /> Slato License Number CoNract Price of Work <br /> �F�r9? �' �l�o�iu' /'�c�t(..�.J <br /> Proposed Use o Buildinc� Contact Person (Plan Revicw) <br /> Description of Work to Oe Done: �/Pr�a-,O 17�'<</z�L <br /> i . <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�5 3105 <br /> 1 hereby certily fhat I have road and exurnined fhis application and know fhe sarne fo Ue frue and <br /> correcL .411 provisions o/laws and ordinances goveming fhis type oI worlc rvill be complefed <br /> whefher spec�lied herein or noL Thc c�ranfing ol a porrnd does nof resume fo give aufhonty to <br /> riolafe or cancel fhe provisions ol any other sfate or local low reguPting wnsWction or the <br /> peNonnance o/consfniction. That I am authonzed by fhe owner o/this propert}�to perforrn the <br /> work lor which applicafion is rnodo and 1 compty u�ith the Sfate Cnntracfors Law 18.27 RC W and <br /> 296.200 WAC. <br /> � � ✓ <br /> /. <br /> .-���7�.�� ,� �� � afi <br /> �� Si�nalure Uat <br /> �(�lb't'a �l,y� � <br />