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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I-17"�b <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org �Cj(� p ( �D� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> <> �� <br /> ^�3/,�2 /,��,tG�rd� ���_� . � �u, <br /> PROJECT ADURESS <br /> i <br /> /i-;�'� �«lu�..��� . ��3�3 �%�d�, ,�r. ��;��r�rr ;�i�'9k�o8 i,>>�/�r�-/.�, <br /> Own � Mail Address Ciy Stale/Zip Phone <br /> ��;'„�,;��/, 'd��' �?3��2 ��,M,G��,�,<< < ;��� �l'/r,� r`"'���i <br /> e n� Mail Address City State/Zip Phone <br /> �,�1%lG'l�C'�� <br /> � <br /> Electrical Contractor Mail Address City SWtelZip Phone <br /> Stale License Number Contract Price o(Work <br /> < /�f�t�'�(��rc'� /.c�t/i2 ( <br /> Proposed Use of Build' g Contact Person (Plan Reviewl <br /> Descriplion of Work to Be Done: �l/i«Cl,ir �/�« r1�i� �S'✓' �lN ff.� �T/!/i'.�r ��0-� <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 /> 1 hereby certily Ihat 1 have iead and examined fhis applicafion and know fhe same to 6e true and t GUbI-(�j"� <br /> correct. All provisions ollaws and ordinances governing fhrs type oI work will be completed <br /> whether specdied herein ar noL The g�anfing ol a permd does not presume to give authonty fo <br /> violate or cancel the provisions o(any other state or lor,al l�w regulafin�construc6on or fhe <br /> per/onnance oI consfrucfion. Thaf I am authorized by the owner o/fh�s property to perform(he <br /> work lor�vhich applicafion is made and I comply with the Stafe ConVacfors Law iff.27 RCW and <br /> 296.200 WAC. / <br /> � , � - �- � / Gr <br /> :f.���. � ;�/�:� _ i_ � - � - <br /> � Si�ijUlurC—��� Date <br />