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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 A�1 TO 4 PM <br /> i � C� �l Y i /�I r,� — <br /> __, <br /> PROJECT ADDRESS <br /> %1 s z�� -v �L <br /> / �� � /��i2i�j� �7� f�0 %T /�✓ F/Firr`t T W� ' ��� / <br /> Owner Mail Address Cily Slate/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> /1r' I�,}r�1�/ `r�CT PiJ ?rX �Cy L'f.✓-✓w�a�� 9dU:'G �f7�- 776 9�9_3 <br /> EleClriCal ConlfaCtof Mail Address City Slale2ip Phone <br /> )�Gr I)�f(�1 93G C( � �'y00 <br /> Slate License Number Contracl Price of Work <br /> /�� S ! [) � �� Tl i) L <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: l �v S /�i��— v T�R T �l .�- �id.=i'Li7'��` <br /> �� SFii T <br /> NOTE: WIRING IN NON-DV�!ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, N1C OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 <br /> 1 hereby ce�1ily fhat I have read and examined fhis applicofion and know the same fo be true and j% ` � � � �l � <br /> correcL All provisions o�laws and ordinances�oveming fhis type o!work will be compfeted �� <br /> whether specilied herein or not The c�ranting of a pernut does nof presume to give aufhonty lo <br /> violate or cancel the provisions of any o(her state or local law regulating constniction or the <br /> performance o/construcfion. Tfmt I am authonzed by the o�rner o/this propeRy fo perform fhe <br /> �vorl<fer which application is made and 1 comply�vifh fhe State Confractors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> � <br /> � �-, � . l� ��"'�t�� �D - S — �� <br /> ' � Signature Date <br />