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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 '2 _'� �� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �p � r2�ll(p <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 5 �� (� �''���JZ� <br /> PROJECT ADCRESS <br /> �0 2 rJ ;'�'S� ��'�i2 !S2 5 ��r,�'a�0 �L.�c;'� L�- - <br /> Owner Mail Address Ciry Statelup Phone <br /> Tenant A4ail Address Ciry Slate/Zip Phone <br /> u� <br /> S��Sk�i� ���-�i c 7 S2 5 �-� �rY���r�rt � q8,-r� .l�/-� ��� <br /> Electrical Conlractor Maii nddress Ciry v State2ip Phone <br /> . �� � \ �- �/' / <br /> �j'� f� -5�1�.1 ( ( o �'� � ' �� 700 � � <br /> State License Number Contract Price of Work <br /> S� ��sf . <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �J 1�-� N � i�� �-�i- �'�(�-t=�-c L� 61-�1 <br /> Description of Work to Be Done: ` <br /> �� � ��1'T''Cf"1 :,�i <br /> � NOT[: WIkING IN NON-DWELLINGS IS REQUIRED TO f-EE <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRily fhat 1 have read and examined this application and know Uie same to be Vue and <br /> conecL All provisions ollaws and ordinances govenung Ihis type o/work will be completed <br /> whether specilied herein or noL The aranting of a permd does nof resume to give aufhonty to <br /> violate or cancel Ihe provisions o/any o(her sfate or local la�v reguPting construction or the <br /> pe�formance o/cons(ruc6on. That I am authorized by the owner ol fhis property to perfonn fhe <br /> �vork�or which applicalion is made and 1 compty with the Sfate Confractors Law 18.27 RCW and <br /> 296200 WAC. <br /> ,,;: _ � � _ � <br /> �� z , <br /> - igna ure� Date - <br /> , � - J � �- <br /> �i��J�{�) � W I ���.S��� S,S � I C <br />