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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> � � �4 �:���i��� �'I�'f:�^L'� JJe:r� <br /> PROJECT ADDRESS <br /> 4-ZS <br /> j �1v� ,.�, �ess�er go� C�r-��t? i4v� �.v�r�.t-t_' ���} � �?/ 2yq- �z�R <br /> Owner Mail Address City Slate/Zip Phone <br /> ��'���-:� ,,—��<��e� I S 74--t.n,-u�a� A v� Eue re-tCl �,tlA 9�'�l n��0 3 E�i- <br /> Tenant � Mail Address City State/Zip Phone <br /> -�-7•� <br /> ��c� �,�i�� gr� GrG� ,�t � �( ',��t�' ��),�i qk'�nl 2s;`Iz.(^� <br /> Electrical Contractor Mail Address Ciry State/Zip Phone <br /> State License Number Contract Price of Work <br /> 4 L� <br /> ��a r�t. c'� `l�w�e� ��E'S:�1N(� 3n3-�"� <br /> Proposed Use of Bulding Contact Person (Plan Review) <br /> Description of Work ta Be Dane: ���i r� Vlr�-' "j�i�<jF � i "+'/ii� O�'�`-"�- 2. r',�.ir n cr i� ir(,°{"S <br /> � � / <br /> � rwfv��I��tfis I att'i l �c brf' '� �1���'�� T I�hYS r (�C� /rYl� l�!/�F� -'_____ <br /> � 2'�' ✓ci`T a;rt�T , c�;��.rt,.� <br /> �r`r :P/�' �:)r?!� 1/PC_�� ��" �"�'� "f' ���"l� � i (('r`I'- �"(;(' G_� I.J 1"�c� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> � ' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> ' � I hereby certi�y that I have read artd examined fhis application and know Ihe same tu be true and <br /> I I correct All provisions ollaws and ordinances govemmg th�s type of work will be completed <br /> I whefhe�specdied herein or nof. The granting of a permrt does not presume to qive authonty to <br /> violate or cancel the provisions of any other state or loca�iaw regulatiny construcnon or the <br /> peAormance ol construcLor,. That!am authorized by the owner o(this property to periorm the <br /> wcrk lor whmh application ia made and 1 comply with the State Contractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> I <br /> �:. ,. A � ��....=..r 4 I�� (a L�� . ; <br /> � Signa re �ate !. :'�J-� <br /> � =, �� <br />