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ELECTRICAL PERMIT APPLICATI�N <br /> CITY OF EVERET7 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 /> � <br /> /% � � �i�' <br /> � i i l<�- �:, �, <br /> PROJECT ADDRESS <br /> �� % �� I,L.�� �., ' / �� �„�,%/ ,v /o J� / ��bii_ <br /> flG� �'�i/ y l /�� �� .Y(� � �/C� . C�14 <br /> Owner l Mail Address City StatelZip Phone <br /> Tenant Mail Addmss Clty StatelZip Phone <br /> , � �,�-:=� �u23,��,4��� �-�, � y ��„t�l/�i� ������ ���;�,ti-3.�.�,; <br /> Z/ , , � � � �� 2�z , <br /> � State/Zi Phone <br /> Electrical Conlraclor Mail Address City P <br /> /// +-�,�;'�' �'/l// ���' ��� <br /> State License�Number Conlract Price of Work <br /> f�i'�'r-.-�'r`. r�.�i �'CfS.�'+:9c�= <br /> Propose Use of Building Contact Person (Plan Review) <br /> /7�`�'��Nll�dl L � V/7 ,t� �� c� � �� i, <br /> Descri�,:lion o(Work to Be Done: � °� � � �� �C���L�n� > y%��� ��r' <br /> �f *�'<��'.:.'��,/' �a� /-cGuF' �/�'�%!'I%i",� ��„�I"�L/✓4'/'_ ic�//Juv' /�irJ "li?S <br /> [ /, �-, <br /> . <br /> � �; ;y /• , ',/--��- � ' �'.;`/=-.' �r, i' i�%'�j <br /> , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CIT�OF EVERETT LOCAL SALES TA�(CODE IS 3105 ���I� - I 3� <br /> I I hereby r.erfily Ihat I have read and examined fhis applicafion and kno�v the same to be Vue and <br /> I coriecl. All prov�sions o//aws and ordinances ga�eming Ous fype o/�vork will be compleled <br /> 1 whether spea6ed herein or noL The granfing ol a permd does not resume to give aufhonty to <br /> violate or cancel the provisions ol any ofher sfate or local law reguPting construc(ion or the <br /> : perlorrnance o(consVuction. That 1 am authorized,Gy the owner o�fhis properly to perform the <br /> x ' � �vork lor which applicafion is made and I comply wdh the State Contractors Law 1827 RCW and <br /> r 29G.200 WAC. <br /> � <br /> �._—_ . ���i- ,i'c�7 <br /> Signature Date <br /> ------- ------ <br /> 4 <br />