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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 /> 3�0`� ��f�� /�v2, <br /> PROJECT ADDRESS <br /> �J��oC� �ou P 3Go2 `Cu.0 I � J��2 �2�- 2� �v� <br /> Owner �1ail Atldress Cily Slale2ip Phone <br /> Tenant Mail Address Clty State2+p Phonc <br /> �V� <br /> �C�L�� ���c:�� �- (�0 t3o� 1�/�2 �'��wuoc) ,t�'�- r�'29 t ���Z�vYYS <br /> Electrical Conlractor Mail A dress City Slale2ip Phone <br /> !c��J� E 2�3m v y�2c�c5 �" <br /> Slate License Number Conhact Price of Work <br /> Proposed Use of Building Contact Person (Plan Revicw) <br /> > � <br /> Descriplion of Work ta Be Done: e l�l ) l P� >C I��� �1\� �i(�p/� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAB�E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhal 1 have mad and examined this applicafion and kno�v the same fo be Vue and <br /> correct All provisions ollaws and ordinances govenunc�this type ol wo�k wi;l be r.ornplefed <br /> whefhe�spea6ed herein or noL The grantin�o(a perrnd does not resunte fo give authonty to <br /> viola(e or cancel the provisions oI any other state or local law reguPting conslrucfion or fhe <br /> perlormance o/construchon. That I arn authonzed by fhe o�vner o/Ihis property fo perfonn fhe <br /> werk/or which epplication is made and I cornply wifh the State Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> _ ) <br /> �v I � �j <br /> Signat re Datc <br /> � p (��C�� � / C� � <br />