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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-88'10 - FAX 425-257-8857—wvdw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> �—''��� C �/CJ��'7`� �"` `�� <br /> PROJECT ADDRESS <br /> ����l�t,'/�� � ,(� � <br /> C��i L� / �/�7 �7I/CLEj�' .JS�C% �-�'�/2� ����� �C�F'P// �� �i/ <br /> Owner Mail Address City State/Zip ---yyy���Phone <br /> ��J��"���J � <br /> ,L 7�.�� L,C� _ <br /> Tenant Mail Address Gty State/Zlp Phone <br /> �L 3-y�(•i;� J <br /> Electrical Contractor Mail Address City Slate2ip Phone <br /> State License Number Contract Pnce of Work <br /> <-�',� /� -�- . <br /> ��/?�,D,/�_� i ci:-1��iC� <br /> Proposed se of Building ✓ Contact Persnn (Plan Review) <br /> � . � <br /> Description of Work to Be Done: �%Z-���-< <a �-iCs.J . �J L�-����I , � �Zv ��C <br /> I���� ' � ' <br /> '� �.< .r'� L�� ,t�L/l <br /> NOTE: WIRING IN NON-DWELLING.. �S REQUIFFD TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y that I have rnad and examined fhis application and know the same to be true and F �y���— t�� <br /> wrrect. All provisicns ol laws and crdinances goveming this type o(wcrk will be completed <br /> �vhether specified herein or net. The granting ol a permrt does not presume to give authonty to <br /> violate or cancel the provis�ons of any other stafe or lor,al law regu/ating construc6cn or fhe <br /> pe�formance ol construction. That!am authorized by ihe owner o(this propeRy to perform the <br /> �vork for which application is made and 1 comply with Ihe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> � i <br /> ���1�1'//�G���L���� �'7���U� — <br /> Signature Date � <br />