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FLECTRICAL PERMiT APPLICATION <br /> CITY QF 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 <br /> 1'JJ c> > � O/'j'1 �I� r7�"� ��!'c' <br /> PROJECT ADDRESS <br /> Owner <br /> Mail Address City Slale/Zip Phone <br /> Tenant Mail Address Cily Slale/Zip Phone <br /> C'- <br /> �i ��� �� � ��� �- �r�l,�c �� �1�,� �es �T�v�'as� � ���✓� c��6 � 11�4 �i9�: � <br /> Eleclrical Conlractor A9ail Address City StalelZip Phone <br /> � "" ��/ ���D <br /> �!'. , Ii= C J7G� �`� �I-rJ� �/ �_ _� ` <br /> � 1 � � Contracf Pnce of Work <br /> Sta�e License Number <br /> Proposed Use of Building Contact Person (Plan Review) <br /> i <br /> Description o(Work lo Be Done: /ji%��'i lI�" a�j ��' �3 UI�' � ' [. ,'� � 1 �' �f �r <br /> C:1 !r/it'r /"�7���;�1 � � <br /> � <br /> � <br /> NOT[: WIRING IN NON-DWELL.;NGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerii(y that!have read and examined ihis applicafion and know fhe same to be true and <br /> � correcL All prov%sions ollaws and ordinances governing this type of uork will be completed <br /> } �tihether speci'�ed herain or noL The granting o/a perrnd does not presume to give aulhonty fo <br /> violate or cancel fhe provisions of any other state or Iocar law regulafing construction or the <br /> ; pe�fomunce of construction. That I am authorized by the owner of this property to perforrn fiie j <br /> � work for which application is made and 1 comply�roith the Sfate Contractors La�v 18.27 RCW and � � �I . _ <br /> 29Q.200 WAC. � - % <br /> �;/, ,�, , , v <br /> �;-. ,�;� ;��� l::, ,� ,_.,; . � � � _ <br /> ' j Si�nalure ale� <br /> I <br /> L�— _ <br />