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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PEl2MIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 (f d,j�� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org l /�O� 1 <br /> C�'D(�._ oc:� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �`"7 Gl / <br /> � s . �� �jr�j_(. <br /> PROJECT ADDRESS <br /> �/�!t �,, �'� %(� ._�/ _ „1�). �c� �"!-' . .< ��1 �:l'��� ��.'O / �/Z' 1:)�%_.> -�� _ <br /> i <br /> Ownef Mail Address Cily State2ip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> ,- <br /> - � . _ <br /> ����/�i�,l/• J�. �r'•: � >ii✓ i,;c �(, O� �d..�, .'%c�C ��.�Y; �� �-C '� �_'/' � %�J�-,��'? J= ,L � <br /> Electricai Conlractor Mail Address Cily Stale/Zip Phone <br /> � <br /> CY,'-.�f�1,»/ 'l.r. l_. /' /I'�/� �� <br /> Stale License Number Conlract Price of Work <br /> �� <br /> ��'��• /:.�I:- � — <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Descriplion of Work to Bc Done: -- � �i"' '�- �i;, ,i<."a� ��,-c �; �` - <br /> � NOTE: WIRING IN NON-DWELLINGS 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 certily thaf 1 have read and examined this applicafion and know the same fo be true and <br /> correct. All p�ovisions of laws and ordinances governinc�fhis lype ol work will be complefed '=0�W`y��'� <br /> whether speabed herein or noL The grantinc�o/a pernut does not resume fo give authonty to <br /> violafe or cancei fhe provisions olany other state orlocal law rer�uPting consfruction or the <br /> performance o(construction. That 1 am authonzed by Ihe o�vner ol fhis property fo perform the <br /> work Ior which application is made and I comply with fhe State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> - ' � . <br /> -=- ' /�`�G�%� '; - �'� - <br /> Si9nature Datu <br />