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ELE�T�ICAL 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 /> . � , �1 <br /> `�.. ,�1'l �a-. �.j � . _ � . ���/1 r'.A�. �,,,�;� � �U `�, "c <br /> PROJECT ADDRESS <br /> Owner Mail Address Cily Stale2ip Phone <br /> '� � <br /> � � �, i� i ii �- . .. <br /> Tenant Mail Addross City State/Zip Phone <br /> �y /� 3�,� <br /> �:i (; ;,: �. 11 c ,.�i .��_ '�',,�,t�"I.t ;�; dtc.t'1I'� {�1�JA ��"�'` l-'�I �(L;.���L,��\�w (,Jh `��vLl� lsC1 u"1 . <br /> Elecirical Conlraclor Mail Address City State/Zip Phone <br /> �j�'� (llr.� 6 ��ipl ,'���i ����JJ <br /> Slale License Number Conlract Price of Work <br /> ��;� , . <br /> Proposed Use of Building Conlact Person (Pian Review) <br /> Descriplian of Work to Be Dona: `��'': ' ��r" ;�`':` ' �`� ` �'( ! �Uv ? "r l <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CI'fY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l hereby certily thaf 1 h�ve read and examined th%s application ar.d know tbe same to be t�ue and <br /> correcL All provisions o/laws and ordinances c�overning fhis type o!work wi(1 be completed <br /> whelher specified herein or noL 1'he grantin�o/a penmt does nof uesume to give au0iority to � <br /> violate or cancel fho provisions o(any other state or fecal law regu�ating cons(ruction or the � <br /> pedormance of construc6on. 7hat 1 am authonzed by fhe owner ot this property to pe�form the <br /> work!or u�hich application is made and I comply�vilh the State Confractors La�v 18.27 RCW and I y�- <br /> 296.200 WAC. + � l, <br /> _., - '�... ,,� �� I <br /> �� �,� �' <br /> Signature �ate <br />