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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 / � C^ -U�� <br /> v ` c <br /> / C��!; <br /> � � 0 � � <br /> ' � � � I/e�e � lfU �� �i/✓ <br /> PROJECT ADDRESS <br /> ��'l.�-'1�rJ1_'J11I�1Gor �/G �I�KII �cV .S('�C-Gl/ch^�/�/ �1�� �3��%J _ <br /> Owner Mail Address � City Stale/Zip Phone <br /> / 1 \� �/ <br /> Jr`i.. , - 4.ry �!V �'p( iS� <br /> TenaN A1ail Address Cily Slale/Zip Phone <br /> �1�� ��' .�/,'(i� / /ZI �i S/l Z.f �-14P � 'JJur��i�ycn (''✓/! / ��31 31n-7.�+3/ �.-� <br /> Eloctrical Conlractor M11ail Address City State/Zip Phone <br /> �:n�c ��� � oz ?-�� �T � �7 G>��CD <br /> , <br /> Slale License Number Contract Price o(Work <br /> � ,/ t /�f, /> <br /> 'n�/��S I G (�(� �C�. .SJ<�,�,.� ( �..i�O.�nn <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �/ <br /> Description o(Work lo f3o Done: ��L � ��t��n t /�, � �G✓�'a.+ � <br /> /' �{�/e d �� 9�/�,�,� �%.� d c•�r7��7�5' <br /> � � <br /> NOTE: WIRING IN NON-DWEL�INGS 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 cerlily fhaf I have read nnd examined fhis application and know fhe same to be frve end <br /> correcL All provisions o(laws and ordinancos gorenung th�s type of u�o�ic will be complefed <br /> whefher specified herein or noL Tho g�anting of a pertnd does nof presume to give authonq�fo <br /> violafe or cancel lhe provisions of any other stafe or locnl law rec�ulnting construcfion or fhe <br /> pedonnance o(consiruction. T/taf I am aufhoiized G}�the o�rner o/fhis property to perfomi the <br /> work Io,-�rhich application is mado and 1 cornpty with fhe Sfafe Confmctors Law 18.27 RCW and <br /> 296.20 WA�% � <br /> -�`�� ,,� <br /> � ��;-- � -�� -�,-� , �� <br /> Si�naWre Dale ^..,I„ <br /> �U� <br /> � <br />