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1 <br /> ELECTRICAL PERMIT APPLICATION <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 /> (. �-,� ;� � �:�- � t��c y <br /> PROJECT ADDRESS � <br /> � � _ — �' f. ., ,,_; <br /> , _ ri�'. .•�� I�i. ;- ,'�ii-'G� i�/ �`7 . � ../` � ' -��..� j/ " ,�:�c-�i,��! -� / i'i i <br /> Own�r Mail Address � City StalelZip Phone <br /> 1��' <br /> � / -.�-i;i.��5 .y <br /> Y �! �. } �7" <br /> Tenanl Mail Address Cily State/Zip Phone <br /> ��;'i- <br /> EleclriCal Contraclor htail Address Ci1y StatelZip Phone <br /> Slate License Number Contract Price o(Work <br /> � � <br /> ls�� >, �/�����7 <br /> Proposed Use of Buildin� Conlacl Person (Plan Review) <br /> Descriplion of Work lo Be Done: v/'�L/ �1 �L% /��r °> �'�c � �� t"c-*/.�i C i, .G <br /> � � • / �/ , �( /' <br /> SF- � .L.C-' 1 '�i �%!-� �/ / i � C. "l 7 .. �/� / ✓ ���E' C .-L'/Z(r..y/-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 IS 3105 <br /> � 1 hereby certily thaf I have read and exarnined fhis opplication and kno�v fhe same to be true and <br /> correcL All provisions o(laws and ordinances goveming this lype of n�ork will be completed <br /> whether specified herein or not. The c�ranting ol a pernut does not nesume fo give authonty to <br /> violate or cancel fhe provisions ol any o(her state or local law regulefing consfrucfion or fhe <br /> performance o/censtruction. Thnt 1 am authorized by the owner o/fhis property fo peAorm Ihe <br /> wak lor�vhich application is rrade and 1 comply�vifh the State Confractors Lan� 18.27 RCW and <br /> 29G.200 L1�AC. <br /> Si9nature Date <br /> ��7G2- -U`�-( <br />