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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, W.4 98201 / �-a��6 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �y�(� I a�I a� <br /> APPLICATIO�S ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,����c'�� �. .�.-(,'r7.c/J ,�!'� C�7'e�.�.�i.. <br /> PROJECT ADDRESS <br /> ;, T�. � � P� -,-,,,.;�� 1>• �� x /i/��: f'rr>�; �! �[ A %,5'.a�-� C'f�.5)a.>7. �:. ��� <br /> OWnef� Mail Addrus City Slate2ip Phone <br /> Tenan� Mail Address City State2ip Phone <br /> ,),•�'t �.<� �"� ,..�r �',%nil�� �G/5�/5'�S� .SiU�//xlin.si> /t/r� `�,Y:C'i/��Go�S�:G �`.'!G' <br /> � <br /> EledricalContrado� Ma?IAddress City Slate2ip � Phone <br /> r <br /> �%� �� � /[��� Ti �. �f /��l . <br /> State License Number Contrad Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descnption of Work to Be Done: 1��I/ /,'���� i��Y i��-- � I��/����-`� _ __ <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 /> I hereby certify Ihat I l�ave read and oxamined tliis applicafion and know the same to be frue and <br /> correcc All provisions ot/aws and ordinances govemmg this type ol work will be comp/eted <br /> whethor specified herain or not. The granting oI a permd doos not presume lo give aufhonty to <br /> violate or cancel the provisions oI any other sfafe or local law regu/afing cronstruction or the <br /> perlormance ot consfruction. That I am authonzed 6y the owner ol fhis property lo pedorm the • �_. <br /> work Ior which application is made and I comply�vifh fhe Sfate Contractors Law 18.27 RCW and ��- G�Il' _ /� /, <br /> 296.200 WAC. �, \ � <br /> /) <br /> �';c �_�.I._�i� ����I��" <br /> " � Blgnature � ate i <br />